The Study of Influence on the Clinical Characteristics of Striatocapsular Infarction with Different Degree Middle Cerebral Arterial Stenosis and Correlative Factors for Outcome of Striatocapsular Infarction with Bad Prognosis
|Keywords||Striatocapsular Infarction Middle Cerebral Artery Stenosis or Occlusion Acute MagneticResonance Imaging Diffusion Tensor Imaging Clinical Outcome Risk Factor|
[Objective]To investigate relationship between clinical outcome of patients with striatocapsular infarction and middle cerebral artery occlusion or stenosis.[Methods]A total of50patients with striatocapsular infarction had brain and neck magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) within72h after onset were recruited. They were evaluated the occlusion or stenosis of MCA. In this study, the stenosis rate of M1less50%was designated as good and more then50%as poor. Base material, volume of infarction, progressive motor deficits, risk factors, NIHSS score and mRS score were compared between two groups. Then we evaluated the difference of lowered Fractional Anisotropy (LFA) on diffusion tensor imaging between the good and poor outcome.[Results]1. Clinical features between the good and poor vascular group:Good vascular were observed in26patients. The rate of diabetes mellitus rate, low density lipoprotein, infarction volume and progressive motor deficits were significantly different (p=0.011,0.001,0.001,0.025respectively). After30days the rate of neurological function improvement was lower in the poor vascular group (p=0.042).2. Early progressive motor deficits:Early progressive motor deficits occurred in21patients, who had lower neurological function improvement (p=0.061). Compared with without progressive motor deficits group, MCA stenosis rate, diabetes mellitus rate, diastolic pressure, random blood glucose, NIHSS on admission were significantly different (p=0.025,0.007,0.032,0.029,0.013respectively). Independent factors for diastolic pressure on admission were evaluated using a logistic regression (OR=1.124,95%CI1.012-1.247, p=0.029).3. The clinical outcome:28patients had bad clinical outcome after30days. Compared the good outcome group, diabetes mellitus rate, cholesterin, diastolic pressure, random blood glucose, NIHSS, progressive motor deficits and MCA stenosis rate were significantly different (p=0.007,0.026,0.032,0.029,0.013,0.061,0.042respectively). LFA was Independent predictor of neurological function improvement of patients with striatocapsular infarction.[Conclusions]Patients with MCA M1stenosis or occlusion had higher early progressive motor deficits rate and bad clinical outcome. Diastolic pressure is Independent factors for progressive motor deficits. LFA can predict neurological function improvement of striatocapsular infarction.