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Transoesophageal echocardiographic findings in patients with ischemic lacunar and nonlacunar stroke

Ozlem Cokar1, Oya Ozturk, Tuba Aydemir

  • 1Department of Neurology, Haseki Educational and Research Hospital, Istanbul, Turkey. ozlemcokar@yahoo.com

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|January 22, 2008
PubMed

Insights

This study found hypertension and diabetes mellitus are key in both lacunar and non-lacunar infarcts. Careful cardiac evaluation is crucial, even for lacunar infarct patients, to identify potential cardioembolic sources.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Ischemic stroke classification includes lacunar infarcts (LACI) and non-lacunar infarcts (NLACI).
  • Identifying cardioembolic sources is vital for stroke management and prevention.
  • Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are used to detect cardiac abnormalities.

Purpose of the Study:

  • To compare risk factors and cardioembolic sources in patients with LACI and NLACI using TTE and TEE.
  • To determine the prevalence of cardiac embolism sources across different stroke subtypes.

Main Methods:

  • Analysis of clinical data from 139 first-time ischemic stroke patients who underwent both TTE and TEE.
  • Patients were categorized into LACI (n=36), anterior circulation infarct (ACI, n=76), and posterior circulation infarct (POCI, n=27) groups.
  • Comparison of hypertension, diabetes mellitus, hyperlipidemia, smoking, age, and sex between groups.

Main Results:

  • Hypertension and diabetes mellitus prevalence did not differ significantly between LACI and NLACI groups.
  • Potential cardioembolic sources were identified in 44% of LACI, 52.6% of ACI, and 55.5% of POCI patients.
  • Atrial fibrillation was more frequent in the ACI group.

Conclusions:

  • Hypertension and diabetes mellitus play equally significant roles in both LACI and NLACI pathogenesis.
  • Thorough cardiac evaluation is necessary for all ischemic stroke patients, including those with LACI, to detect potential cardioembolic sources.

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