Mechanism of stroke in patients taking aspirin.
During a 1-year period, we prospectively studied the mechanism and severity of stroke in 47 patients sustaining a cerebral infarction while taking aspirin. The mechanism of stroke was undetermined in 12 patients (26%). In the remaining 35 patients, we identified 39 potential mechanisms: large-artery atherosclerosis (19 patients, 40%), cardioembolism (15 patients, 32%), and small-vessel occlusive disease (5 patients, 11%). Of 11 patients with carotid atherosclerosis and stroke, 9 (82%) had greater than 90% carotid stenosis or occlusion; of 12 patients with stroke of undetermined mechanism, 10 (83%) had previous stroke, of which 8 were also of undetermined mechanisms. Disability after stroke was moderate or severe in 27 patients (57%). These data suggest that (1) stroke in patients taking aspirin has a variety of etiologies and frequently causes moderate or severe disability; (2) patients with carotid disease failing aspirin often have high-grade carotid stenosis or occlusion; (3) stroke of undetermined mechanism may recur more frequently than other stroke subtypes in patients taking aspirin.
Chimowitz
M I
MI
Department of Neurology, Cleveland Clinic Foundation, OH 44195.
Furlan
A J
AJ
Nayak
S
S
Sila
C A
CA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000503:physiopathology; D002544:Cerebral Infarction / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000503:physiopathology* / Q000517:prevention & control / Q000534:rehabilitation; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000503:physiopathology; D002542:Intracranial Embolism and Thrombosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D001241:Aspirin