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Updated: Sep 8, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Coexisting causes of ischemic stroke
J Moncayo1, G Devuyst, G Van Melle
1Department of Neurology, Centre Hospitalier Universitaire Vaudois, CH 10-11 Lausanne, Switzerland.
Background:
Coexistence of multiple potential causes of cerebral infarct (MPCI) has been poorly studied.
Objective:
To determine the risk factors, clinical findings, and topographical patterns of patients with at least 2 potential causes of cerebral infarct.
Design:
Data analysis from a prospective acute stroke registry (the Lausanne Stroke Registry, Lausanne, Switzerland) in a community-based primary care center.
Results:
Among 3525 patients with first-ever ischemic stroke consecutively admitted to a primary care stroke center, 250 patients (7%) had at least 2 MPCIs, with the following subgroups: large artery disease and a cardiac source of embolism (LAD + CSE) (43%), small artery disease and CSE (SAD + CSE) (34%), LAD + SAD (18%), and LAD + SAD + CSE (5%). Hypertension, cardiac ischemia, and a history of atrial fibrillation predominated in the LAD + SAD + CSE subgroup (P<.001), while cigarette smoking was more prevalent in the LAD + SAD subgroup (P<.05). A decreased level of consciousness and speech disorders were more common in the LAD + CSE subgroup (P<.001). Lacunar syndromes predominated in the LAD + SAD subgroup. Pure motor stroke was the most frequent lacunar syndrome in all subgroups, but sensory motor stroke predominated in the LAD + CSE subgroup (P<.05). The outcome at 1 month was worse in the LAD + CSE and SAD + CSE subgroups (P<.001). Other stroke characteristics and clinical features did not differ significantly between the 4 subgroups of patients with MPCI.
Conclusions:
Our findings suggest that MPCIs are uncommon. The most frequent association is LAD + CSE. Topographical patterns of stroke and clinical characteristics in patients with MPCI only rarely allow emphasis of a preeminent cause. Arch Neurol. 2000;57:1139-1144
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