Background
Patients of small subcortical infarction sometimes have neurologic deterioration (ND),
with the risk factors and specific pathogenesis unclear. Small subcortical infarction
is often accompanied by other phenotypes of small vessel disease such as leukoaraiosis,
which indicates the white matter hyperintensities in the deep or periventricular areas
on the fluid-attenuated inversion recovery series of magnetic resonance images and
was proved to be associated with stroke in various aspects. In this study, we intended
to investigate whether leukoaraiosis was associated with ND after small subcortical
infarction, and explore other possible risk factors of ND.
Methods
Patients with single acute subcortical infarction (<1.5 cm in diameter) were recruited
consecutively and evaluated everyday. ND was defined as worsening by 2 points or more
in the National Institutes Health Stroke Scale (NIHSS) score, or by 1 point or more
in the NIHSS score for motor function within 1 week after stroke onset. Leukoaraiosis
was rated according to the age-related white matter changes scale. Univariate and
multivariate analyses were performed to identify the risk factors for ND.
Results
Eighty-four of 435 patients (19.31%) had ND. Univariate analysis showed that age,
severity of leukoaraiosis, baseline NIHSS score, presence of diabetes, hemoglobin
A1c, and total cholesterol levels were all associated with ND. Multivariate analysis
further identified that the severity of leukoaraiosis especially leukoaraiosis adjacent
to the index infarction, baseline NIHSS score, and diabetes were independently associated
with ND.
Conclusions
Severity of leukoaraiosis and baseline neurologic deficits, and the presence of diabetes
were all independently associated with ND after small subcortical infarction.
Key Words
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Article info
Publication history
Published online: March 03, 2014
Accepted:
December 18,
2013
Received in revised form:
December 3,
2013
Received:
November 13,
2013
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.12.032
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
