Prevalence of subdiaphragmatic visceral infarction in cardioembolic stroke.
BACKGROUND
A substantial proportion of ischemic strokes have an embolic mechanism, but the source of embolism is not detected. Coexistence of subdiaphragmatic visceral infarction (SDVI; e.g., renal, splenic, hepatic, bowel infarction) may be a suggestion of a common source of embolism. One large autopsy study found SDVI in 21.5% of patients with fatal stroke.


METHODS
We performed diffusion-weighted magnetic resonance abdominal imaging and subsequently performed it in consecutive patients with stroke or TIA and a history of nonvalvular atrial fibrillation.


RESULTS
Among 27 patients, 6 had SDVI (3 recent renal, 1 recent splenic, and 3 old splenic infarction). The median time between onset of ischemic stroke and abdominal MRI was 8 days (interquartile range 3-15 days). No predictive factor of SDVI was found in this study population with respect to demographic or ultrasound characteristics.


CONCLUSIONS
One in 5 patients with nonfatal cardioembolic stroke or TIA may be associated with subdiaphragmatic visceral infarction (SDVI). Further study should evaluate the frequency of SDVI in patients with stroke of unknown cause.
Slaoui
T
T
Department of Neurology and Stroke Center, Bichat University Hospital, Paris, France.
Klein
I F
IF
Guidoux
C
C
Cabrejo
L
L
Meseguer
E
E
Abboud
H
H
Lavalllée
P C
PC
Mazighi
M
M
Labreuche
J
J
Amarenco
P
P
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000473:pathology; D002545:Brain Ischemia / Q000453:epidemiology* / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007238:Infarction / Q000453:epidemiology*; D020766:Intracranial Embolism / Q000453:epidemiology* / Q000473:pathology; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D020521:Stroke / Q000453:epidemiology* / Q000473:pathology; D013997:Time Factors; D014781:Viscera / Q000098:blood supply*