title: Spectrum of single and multiple corona radiata infarcts: clinical/MRI correlations.
abstract: We sought to determine the clinical pictures, topography and pathogenesis of patients with unilateral single or multiple corona radiata infarcts. We defined corona radiata ischemic stroke if the patient had a focal neurological deficit and a relevant non-hemorrhagic infarction confined to the vascular territory of a long medullary artery proved by CT and MRI with contrast. We compared risk factors and clinical feature between subtypes of corona radiata infarcts. The study sample represents 1.2% of the patients (68/5500) with first-ever stroke in our Registry, including ischemic and hemorrhagic strokes. There were 37 patients (54%) with single infarct presenting 17 different complete or partial sensory-motor symptoms with dysarthria; 14 patients (21%) with unilateral multiple infarcts in one hemisphere had often complete sensorimotor deficits with some neuropsychological impairment; among 17 patients (25%) with multiple infarcts in both hemisphere, one half had bilateral motor and sensory symptoms, and neuropsychological deficits, visual field defects were uncommon. Seventeen patients (25%) had dysarthria, which was no localizing value. Hypertension was the most frequent vascular risk factor in 62% of patients, smoking in 28%, diabetes mellitus in 26%, hypercholesterolemia in 9%, and atrial fibrillation in 7%. The main cause of corona radiata infarcts was small-artery disease with long-standing hypertension in 40 patients (59%), large-artery disease in 19%, cardioembolism in 12%. Most of the patients (88%) had leukoaraiosis, and patients with bilateral multiple infarcts, leukoaraiosis was more frequent than in those with unilateral single infarct (P = .016; < .05). Despite clinical similarity to that found in superficial and deep infarcts, incomplete motor and sensory symptoms and MRI allows to delineate simultaneous uni- or multiple infarcts in the corona radiata. After an acute and immediate onset, outcome at 6 months of stroke onset is in general benign except those with bilateral infarcts. The coexistence of small-artery disease with leukoaraiosis suggest similar vascular risk factors and physiopathological mechanism.
authors: Stroke Unit, Department of Neurology, Ege University, Izmir, 35100, Turkey. ekumral@med.ege.edu.tr
authors: Emre
authors: E
authors: Kumral
authors: Gamze
authors: G
authors: Bayülkem