J Clin Neurol.  2008 Sep;4(3):111-115. 10.3988/jcn.2008.4.3.111.

Association of Initial Infarct Extent and Progressive Motor Deficits in Striatocapsular Infarction

• Moon HS
• Kim YB
• Suh BC
• Won YS
• Park KY
• Chung PW

• KMID: 2287674
• DOI: http://doi.org/10.3988/jcn.2008.4.3.111

Abstract

BACKGROUND AND PURPOSE: Progression of motor deficits in the acute period is frequently observed in patients with subcortical striatocapsular infarctions. Therefore, we sought to determine the factors associated with early motor progression in patients with infarcts confined to the striatocapsular region.
METHODS
We studied 80 consecutive patients with striatocapsular-region infarction, as defined by clinical and MRI criteria, within 24 hours after stroke onset. Motor progression was defined as an increase of >2 points in the motor items of the National Institutes of Health Stroke Scale (NIHSS) within 7 days of stroke onset. The study population was divided into patients with and without motor progression, and risk factors, clinical features, and brain MRI/magnetic resonance angiograpy (MRA) findings were compared between these groups.
RESULTS
Motor progression was observed in 40% of the 80 patients. The independent variables associated with motor progression were a history of hypertension (OR=7.8, 95% CI=1.5-39.8, p=0.013) and an initial infarct extent of > or =15 mm (OR=9.2, 95% CI=1.8-45.7, p=0.006). However, there were no differences in the initial NIHSS score, other stroke risk factors, vascular stenosis pattern, or cardioembolic source.
CONCLUSIONS
Early motor progression in patients with striatocapsular-region infarction is associated with the initial extent of the lesion. However, the stroke mechanism and vascular stenosis did not differ between the motor progression and stable groups.

Keyword

Striatocapsular infarction; Magnetic resonance imaging; Acute stroke; Stroke progression; Motor deficit; Subcortical infarct

MeSH Terms

Brain
Constriction, Pathologic
Humans
Hypertension
Infarction
Magnetic Resonance Imaging
National Institutes of Health (U.S.)
Risk Factors
Stroke

Figure

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  Fig. 1 Selection of patients. NIHSS: National Institutes of Health Stroke Scale.

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  Fig. 2 MRI findings of striatocapsular-region infarction. A: Initial DWI image of an 81-year-old female with an initial score of 6 on the NIHSS who suffered motor progression (NIHSS score of 10) during admission, which shows right striatocapsular infarct (lesion diameter of 32 mm) extending to the corona radiata. B: Initial DWI image of a 51-year-old man without motor progression (NIHSS score of 3), which shows small striatocapsular infarct (lesion diameter of 14 mm) extending to the corona radiata. DWI: diffusion-weighted imaging, NIHSS: National Institutes of Health Stroke Scale.

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