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Increased arterial pulsatility and progression of single subcortical infarction

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Abstract

Objective

We investigated the association of clinical, laboratory, sonographic and imaging parameters, in the progression of single subcortical infarctions.

Methods

Consecutive 169 patients with lacunar (n = 89) and striatocapsular infarctions (n = 80) in the middle cerebral artery (MCA) territory with nonstenotic MCAs were recruited and examined for stroke progression. The pulsatility index (PI) was measured by transcranial Doppler from ipsilateral M1.

Results

The striatocapsular infarction group exhibited more stroke progression. The patients with progressive lacunar infarctions had more diabetes, higher HbA1c levels, and higher initial National Institutes of Health Stroke Scale (NIHSS) scores, and the patients with progressive striatocapsular infarctions had more hypertension, higher cholesterol levels, and higher NIHSS scores. The MCA PI was higher in the lacunar infarction patients with progression (0.99 ± 0.19 vs. 0.90 ± 0.14, p = 0.048), while the striatocapsular infarction patients did not differ according to progression. From a multivariate analysis, higher MCA PI were independently associated with lacunar infarction progression (by 0.1 increase, OR 1.51; 95 % CI 1.06–2.15; p = 0.024).

Conclusions

Higher pulsatility was associated with progression in lacunar infarction. PI measured by transcranial Doppler sonography might reflect downstream arterial resistance and vascular/paravascular perfusion status and be a possible indicator of stroke progression.

Key Points

• Higher pulsatility index was observed in progression group of lacunar infarction patients.

• Higher pulsatility index seemed to be associated with progression in lacunar infarction patients.

• Differences in the factors associated with stroke progression suggest different underlying pathophysiologies.

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Acknowledgments

The scientific guarantor of this publication is Keun-Hwa Jung. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by the Seoul National University Hospital Research Fund (04-2015-0880). No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was waived by the Institutional Review Board. Methodology: retrospective, observational, performed at one institution.

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Authors and Affiliations

  1. Department of Neurology, Laboratory for Neurotherapeutics, Biomedical Research Institute, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 03080, South Korea

    Keon-Joo Lee, Keun-Hwa Jung, Chan-Young Park, Soon-Tae Lee, Kon Chu, Manho Kim & Sang Kun Lee

  2. Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea

    Keon-Joo Lee, Keun-Hwa Jung, Chan-Young Park, Soon-Tae Lee, Kon Chu, Manho Kim & Sang Kun Lee

  3. Department of Neurology, Chung-Ang University Medical Center, College of Medicine, Chung-Ang University, Seoul, South Korea

    Jeong-Min Kim

  4. Department of Neurology, The Armed Forces Capital Hospital, Seongnam, South Korea

    Jae-Kyu Roh

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  1. Keon-Joo Lee
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Correspondence to Keun-Hwa Jung.

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Lee, KJ., Jung, KH., Park, CY. et al. Increased arterial pulsatility and progression of single subcortical infarction. Eur Radiol 27, 899–906 (2017). https://doi.org/10.1007/s00330-016-4486-0

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  • DOI: https://doi.org/10.1007/s00330-016-4486-0

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