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Risk factors for small cortical infarction on diffusion-weighted magnetic resonance imaging in patients with acute

Chisako Yano1, Makoto Iwata1, Shinichiro Uchiyama1

  • 1Department of Neurology, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|June 29, 2010
PubMed

Insights

Carotid disease and coagulopathy are key risk factors for small cortical infarction (SCI) in acute ischemic stroke patients. Diffusion-weighted MRI helps identify these lesions and their associations with underlying conditions.

Area of Science:

  • Neurology
  • Radiology
  • Cardiology

Background:

  • Diffusion-weighted magnetic resonance imaging (MRI) is crucial for detecting acute ischemic lesions.
  • Small cortical infarction (SCI) represents a subset of acute ischemic stroke.
  • Understanding risk factors for SCI is essential for targeted prevention and treatment strategies.

Purpose of the Study:

  • To evaluate risk factors associated with small cortical infarction (SCI) detected by diffusion-weighted MRI.
  • To investigate the relationship between specific risk factors and the localization of SCI.
  • To identify independent predictors of SCI in patients with acute ischemic stroke.

Main Methods:

  • Retrospective analysis of 123 patients with acute ischemic stroke.
  • Definition of SCI as cortical lesions < 1.5 cm diameter on diffusion-weighted MRI.
  • Assessment of risk factors including hypertension, hypercholesterolemia, diabetes, smoking, cardiac sources, carotid disease, and coagulopathy.
  • Analysis of plasma coagulation and fibrinolysis markers.
  • Comparison of risk factors across different SCI localizations.

Main Results:

  • SCI was identified in 22.8% of patients.
  • Carotid disease (OR=4.4) and coagulopathy (OR=6.8) were independent risk factors for SCI.
  • SCI with carotid disease was not linked to bilateral lesions, while SCI with coagulopathy was.
  • No borderzone lesions were observed in SCI patients with cardiac sources.

Conclusions:

  • Carotid disease and coagulopathy are significant independent risk factors for small cortical infarction.
  • The localization of SCI varies depending on the underlying etiology, such as carotid disease, coagulopathy, or cardiac sources.
  • Diffusion-weighted MRI is a valuable tool for diagnosing SCI and understanding its associated risk factors.

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