Large subcortical infarcts: clinical features, risk factors, and long-term prognosis compared with cortical and small deep infarcts

Stroke. 2006 Jul;37(7):1828-32. doi: 10.1161/01.STR.0000226993.88307.ff. Epub 2006 Jun 1.

Abstract

Background and purpose: In this study we compared risk factors, clinical features, and stroke recurrence in a large series of patients with large subcortical, cortical, or small deep infarcts.

Methods: Patients with a transient or minor ischemic attack (modified Rankin Scale grade of < or =3) who had a single relevant supratentorial infarct of presumed noncardioembolic origin on CT were classified as suffering from a large subcortical (n=120), small deep (n=324), or cortical (n=211) infarct. Mean follow-up was 8 years. Rates of recurrent stroke were compared with Cox regression.

Results: The clinical deficits caused by large subcortical infarcts resembled either those of a cortical or those of a small deep infarct. Risk factor profiles were similar in the 3 groups. The rate of recurrent stroke in patients with a large subcortical infarct (25/120; 21%) did not differ from that of patients with a cortical infarct (46/211; 22%) or with a small deep infarct (60/324; 19%). After adjustment for age, sex, and vascular risk factors, hazard ratios for recurrent stroke of large subcortical and cortical infarcts were 1.05 (95% CI, 0.65 to 1.70) and 1.17 (95% CI, 0.79 to 1.73), respectively, compared with small deep infarcts.

Conclusions: Clinical features, risk factor profiles, and stroke recurrence rate in patients with a large subcortical infarct only differ slightly from those in patients with small deep or cortical infarcts.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aspirin / therapeutic use
  • Brain / blood supply*
  • Cerebral Cortex / blood supply*
  • Cerebral Infarction / classification*
  • Cerebral Infarction / epidemiology
  • Cerebral Infarction / pathology
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Ischemic Attack, Transient / complications
  • Ischemic Attack, Transient / drug therapy
  • Male
  • Middle Aged
  • Multicenter Studies as Topic / statistics & numerical data
  • Netherlands
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prognosis
  • Proportional Hazards Models
  • Randomized Controlled Trials as Topic / statistics & numerical data
  • Recurrence
  • Risk Factors

Substances

  • Platelet Aggregation Inhibitors
  • Aspirin