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Infarcts with a cardiac source of embolism in the NINCDS Stroke Data Bank: historical features
S J Kittner1, C M Sharkness, T R Price
1Department of Neurology, University of Maryland, Baltimore.
Insights
Clinical features like systemic embolism, abrupt onset, and reduced consciousness can help identify cardiac embolic strokes. This study analyzed 1,290 patients to assess risk factors for cardiogenic stroke mechanisms.
Area of Science:
- Neurology
- Cardiology
Background:
- Cerebral infarcts can result from cardiac embolism, a significant cause of stroke.
- Identifying the source of embolism is crucial for effective stroke management and prevention.
Purpose of the Study:
- To investigate historical clinical features associated with cardiac embolic strokes.
- To stratify patients with cerebral infarcts based on their risk of a cardiogenic embolic source.
Main Methods:
- Analysis of 1,290 patients with cerebral infarcts from the NINCDS Stroke Data Bank.
- Categorization of patients into high, medium, and low risk groups for cardiogenic embolism.
- Statistical evaluation of the relationship between risk groups and clinical presentation.
Main Results:
- A significant graded relationship was observed between higher cardiac risk and the presence of systemic embolism.
- Increased risk of cardiac source correlated with abrupt stroke onset.
- Diminished level of consciousness at onset was also significantly associated with higher cardiac risk.
Conclusions:
- Specific clinical features, including systemic embolism, abrupt onset, and altered consciousness, are valuable indicators of a cardiac embolic mechanism in cerebral infarcts.
- These findings can aid clinicians in assessing the likelihood of cardiogenic embolism in stroke patients.
- Further research can refine diagnostic criteria for cardiogenic stroke.
Abstract:
To gain insight into the historical features relevant to the diagnosis of cardiac embolic strokes, we studied the 1,290 patients with cerebral infarcts in the NINCDS Stroke Data Bank. Based solely on the presence of cardiac sources of embolism, we divided the patients into groups of high (n = 250), medium (n = 166), and low (n = 874) risk of a cardiogenic mechanism for their stroke. There was a highly significant graded relationship between increasing risk of a cardiac source and a history, or presence of, systemic embolism, abrupt onset, and diminished level of consciousness at onset. These clinical features may be useful for assessing the likelihood of a cardiac embolic mechanism in patients with cerebral infarcts.