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Laminar infarcts in clinical routine: a prospective analysis in standard stroke unit patients

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Abstract

The present study aimed to investigate prospectively the frequency of laminar infarcts (LI) within a standard stroke unit population. Laminar infarcts follow neuroanatomical borders rather than the vascular architecture. The LI are rarely noticed in clinical routine because they are typically not detected by computed tomography. As there is a lack of systemic studies about this specific infarct pattern, little is known about their frequency, clinical characteristics or pathophysiological mechanisms. Consecutive acute ischemic stroke unit patients were prospectively enrolled during a 12 month period. The LI were defined as ischemic lesions following the gyral anatomy of the cerebral cortex. The clinical assessment included a standardized questionnaire, clinical syndromes and standard diagnostic results. There were 491 consecutive ischemic stroke patients enrolled (243 female, mean age 75 ± 12 years). The MRI revealed no laminar lesion crossing vascular territories and 28 patients with LI non-crossing vascular territories (7 %). According to the TOAST classification, 61 % of LI were classified as stroke of undetermined etiology (TOAST V) including 46 % with completed evaluation (TOAST Vb). In contrast to these findings, only 20 % of the whole study cohort with non-laminar infarcts were classified as TOAST V. The results indicate that LI are rare. In clinical routine, patients with LI require particular attention. Within the TOAST classification, this specific infarct pattern seems to be underrepresented.

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Acknowledgments

The study was conducted in the setting of a government-sponsored stroke research project ‘Kompetenznetz Schlaganfall’ (Bundesministerium für Bildung und Forschung, FK 01GI9903) and in the setting of the Center for Stroke Research Berlin (CSB) (01 EO 0801) and supported by DFG DR 323/5-1.

Conflicts of interest

The authors declare no further conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Charite-University Medicine Berlin, Hindenburgdamm 30, 12203, Berlin, Germany

    Annerose Ziegler, Heinrich J. Audebert & Stefanie Leistner

  2. Department of Neurology, Charite-University Medicine Berlin, Chariteplatz 1, 10117, Berlin, Germany

    Jens P. Dreier

  3. Department of Neurosurgery, Klinikum Darmstadt, Darmstadt, Germany

    Frank Bode

  4. Center for Stroke Research Berlin, Charite-University Medicine Berlin, Berlin, Germany

    Jens P. Dreier, Uwe Malzahn & Heinrich J. Audebert

Authors
  1. Annerose Ziegler
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  2. Jens P. Dreier
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  3. Frank Bode
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  4. Uwe Malzahn
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  5. Heinrich J. Audebert
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  6. Stefanie Leistner
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Correspondence to Annerose Ziegler.

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Ziegler, A., Dreier, J.P., Bode, F. et al. Laminar infarcts in clinical routine: a prospective analysis in standard stroke unit patients. J Neurol 260, 2118–2123 (2013). https://doi.org/10.1007/s00415-013-6948-5

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  • DOI: https://doi.org/10.1007/s00415-013-6948-5

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