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Stroke mechanisms and clinical presentation in large subcortical infarctions
1Department of Neurology, Mount Sinai School of Medicine, New York, NY 10029, USA.
Neurology
|December 31, 1997
Summary
Large subcortical strokes, often caused by embolism, frequently lead to cortical signs. This contrasts with small strokes, which typically stem from small-vessel disease and lack cortical findings.
Area of Science:
- Neurology
- Cerebrovascular Disease
Background:
- Subcortical infarcts vary in cause and clinical presentation based on size.
- Large subcortical infarcts are often embolic, while small ones typically result from small-vessel disease.
Purpose of the Study:
- To investigate the embolic sources and clinical manifestations of large subcortical infarcts.
- To determine the frequency of cortical signs such as aphasia, hemineglect, and gaze paresis in patients with large subcortical infarcts.
Main Methods:
- Evaluation of 51 consecutive patients with CT-confirmed subcortical infarcts (≥1.5 cm).
- Assessment for potential carotid or cardiac embolic sources.
- Determination of the occurrence rates of aphasia, hemineglect, and gaze paresis.
Main Results:
- An embolic source (carotid or cardiac) was identified in 63% of patients.
- Carotid and cardiac sources accounted for 23% and 49% respectively.
- Aphasia or hemineglect occurred in 39% of patients, and gaze paresis in 41%.
Conclusions:
- Large subcortical strokes frequently originate from embolic events.
- These strokes often present with distinct clinical syndromes and mechanisms compared to small subcortical strokes.
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