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Increased arterial pulsatility and progression of single subcortical infarction

Keon-Joo Lee1,2, Keun-Hwa Jung3,4, Chan-Young Park1,2

  • 1Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, South Korea.

European Radiology
|July 9, 2016
PubMed

Insights

Higher pulsatility index, a measure from transcranial Doppler, is linked to stroke progression in lacunar infarction patients, suggesting it may indicate vascular resistance and perfusion status.

Area of Science:

  • Neurology
  • Vascular Neurology
  • Neuroimaging

Background:

  • Subcortical infarctions, including lacunar and striatocapsular types, represent a significant cause of stroke.
  • Understanding factors associated with stroke progression is crucial for patient management and therapeutic development.

Purpose of the Study:

  • To investigate the association of clinical, laboratory, sonographic, and imaging parameters with the progression of single subcortical infarctions.
  • To determine if the pulsatility index (PI) measured by transcranial Doppler is associated with stroke progression in different types of subcortical infarctions.

Main Methods:

  • A cohort of 169 patients with lacunar (n=89) and striatocapsular infarctions (n=80) in the middle cerebral artery (MCA) territory were analyzed for stroke progression.
  • Transcranial Doppler sonography was used to measure the pulsatility index (PI) from the ipsilateral M1 segment of the MCA.

Main Results:

  • The striatocapsular infarction group showed more stroke progression compared to the lacunar infarction group.
  • Progressive lacunar infarctions were associated with diabetes, higher HbA1c, and higher NIHSS scores.
  • Higher MCA PI was observed in the lacunar infarction progression group (0.99±0.19 vs. 0.90±0.14, p=0.048) and independently associated with lacunar infarction progression (OR 1.51; p=0.024).

Conclusions:

  • Elevated pulsatility index is associated with progression in lacunar infarction.
  • Transcranial Doppler-derived PI may serve as an indicator of stroke progression by reflecting downstream arterial resistance and perfusion status.
  • Distinct factors associated with stroke progression suggest different underlying pathophysiologies for lacunar versus striatocapsular infarctions.
Abstract

Keywords:
Cerebral infarctionDisease progressionDoppler transcranial ultrasoundInfarction, lacunarStroke

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