Lesion patterns of single small subcortical infarct and its association with early neurological deterioration

Neurol Sci. 2015 Oct;36(10):1851-7. doi: 10.1007/s10072-015-2267-1. Epub 2015 Jun 2.


Early neurological deterioration (END), happening in the acute phase of infarct, is not rare in patients with single small subcortical infarction (SSSI). The aim of this study was to investigate the lesion patterns of SSSI and its association with END as well as functional outcome at 90 days after onset. 227 patients with acute SSSI in the perforator territory of MCA were prospectively recruited from Yangzhou No.1 People's Hospital between May 2010 and Jan 2014 and divided into proximal SSSI (pSSSI) and distal SSSI (dSSSI) according to the lesion patterns. END was defined as a change in National Institutes of Health Stroke Scale score ≥2 points in the first 72 h after admission. Functional outcome at 90 days after onset was assessed using the modified Rankin Score (mRS) and dichotomized as good (0-2) and poor (≥3). Of them, 93 (40.97%) patients had pSSSI and 134 (59.03%) patients had dSSSI. Univariate analysis found that the risk factors profiles differ significantly between patients with pSSSI and those with dSSSI (P < 0.05). During hospitalization, 60 (26.43%) patients experienced END during the first 72 h after admission, and 46 (22.01%) patients had poor outcome at 90 days after onset. After adjusting for potential confounders, pSSSI pattern (OR 2.242, 95% CI 1.165-4.313, P = 0.016) was an independent predictor of END and that the END (OR 2.637, 95% CI 1.208-5.759, P = 0.015) independently predicted the poor outcome at 90 days after onset. The pSSSI patterns might predict END for patients with SSSI in the MCA perforating territory.

Keywords: Early neurological deterioration; Lesion pattern; Middle cerebral artery; Perforating artery; Single small subcortical infarction.

MeSH terms

  • Acute Disease
  • Aged
  • Brain / pathology*
  • Cerebral Infarction / epidemiology*
  • Cerebral Infarction / pathology*
  • Cerebral Infarction / physiopathology
  • Cerebral Infarction / therapy
  • Disease Progression
  • Female
  • Hospitalization
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome