Large subcortical infarcts: clinical features, risk factors, and long-term prognosis compared with cortical and small deep infarcts.
OBJECTIVE
In this study we compared risk factors, clinical features, and stroke recurrence in a large series of patients with large subcortical, cortical, or small deep infarcts.


METHODS
Patients with a transient or minor ischemic attack (modified Rankin Scale grade of < or =3) who had a single relevant supratentorial infarct of presumed noncardioembolic origin on CT were classified as suffering from a large subcortical (n=120), small deep (n=324), or cortical (n=211) infarct. Mean follow-up was 8 years. Rates of recurrent stroke were compared with Cox regression.


RESULTS
The clinical deficits caused by large subcortical infarcts resembled either those of a cortical or those of a small deep infarct. Risk factor profiles were similar in the 3 groups. The rate of recurrent stroke in patients with a large subcortical infarct (25/120; 21%) did not differ from that of patients with a cortical infarct (46/211; 22%) or with a small deep infarct (60/324; 19%). After adjustment for age, sex, and vascular risk factors, hazard ratios for recurrent stroke of large subcortical and cortical infarcts were 1.05 (95% CI, 0.65 to 1.70) and 1.17 (95% CI, 0.79 to 1.73), respectively, compared with small deep infarcts.


CONCLUSIONS
Clinical features, risk factor profiles, and stroke recurrence rate in patients with a large subcortical infarct only differ slightly from those in patients with small deep or cortical infarcts.
Halkes
Patricia H A
PH
Department of Neurology, Rudolf Magnus Institute, University Medical Center Utrecht, Utrecht, Netherlands. phalkes@umcutrecht.nl
Kappelle
L Jaap
LJ
van Gijn
Jan
J
van Wijk
Iris
I
Koudstaal
Peter J
PJ
Algra
Ale
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use; D001921:Brain / Q000098:blood supply*; D002540:Cerebral Cortex / Q000098:blood supply*; D002544:Cerebral Infarction / Q000145:classification* / Q000453:epidemiology / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D009426:Netherlands; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011379:Prognosis; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012008:Recurrence; D012307:Risk Factors
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin