Large subcortical hemispheric infarctions. Presentation and prognosis.
A specific form of large subcortical hemispheric infarction on computed tomography was identified in 24 of 2198 (1%) stroke registry patients. Combined with 13 cases from earlier literature reports, a characteristic neurologic picture developed. Severe face plus arm plus leg weakness at onset (76%), corticallike features of aphasia and/or contralateral neglect (68%), and premonitory transient ischemic attacks (24%) were frequent. Twenty-two patients (59%) had large vessel arterial occlusive disease. Eight patients (22%) had primary embolic occlusion in the middle cerebral artery territory. During an average follow-up of 16 months, five patients (14%) suffered recurrent stroke or death. The clinical presentation and prognostic features of this distinct stroke subtype are described.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001037:Aphasia / Q000209:etiology; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000150:complications* / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology; D011379:Prognosis; D014057:Tomography, X-Ray Computed