High glycated hemoglobin levels and intracranial artery stenosis are predictive factors for early motor worsening events in patients with penetrating artery infarction.
BACKGROUND
The purpose of this study was to identify typical clinical characteristics to predict early motor worsening (EMW) of patients with penetrating artery infarction.


METHODS
We reviewed 65 consecutive patients with pure motor hemiparesis, sensorimotor stroke, and ataxic hemiparesis. EMW was defined as deterioration by ≥1 point on the National Institutes of Health Stroke Scale for motor function within 5 days of admission.


RESULTS
EMW was observed in 22 patients (34%). HbA1c levels were higher in patients with EMW than in those without EMW (7.9 ± 2.6 vs. 6.3 ± 1.6%; p < 0.01). The percentage of EMW patients with intracranial artery stenosis (ICAS) was greater than that of non-EMW patients with ICAS (13/22 patients, 59% vs. 8/43 patients, 19%; p < 0.01). Multivariate logistic regression analysis indicated that HbA1c levels ≥7.0% (OR 3.0, 95% CI 1.5-6.8; p < 0.005) or ICAS (OR 2.3, 95% CI 1.2-4.8; p < 0.05) increased the risk of EMW, and the combination of these factors increased the risk in an additive manner (OR 7.6, 95% CI 2.5-40; p < 0.005).


CONCLUSIONS
HbA1c levels ≥7.0% and/or ICAS in patients with penetrating artery infarction are associated with EMW.
Department of Cardiovascular Medicine, Nephrology, and Neurology, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan. kisaneurology@gmail.com
Katsunori
K
Isa
Hirokuni
H
Sakima
Koh
K
Nakachi
Kazuhito
K
Kokuba
Satoshi
S
Ishihara
Takashi
T
Tokashiki
Yusuke
Y
Ohya
D000368:Aged; D020520:Brain Infarction / Q000097:blood / Q000150:complications* / Q000473:pathology; D016893:Carotid Stenosis / Q000473:pathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D009069:Movement Disorders / Q000097:blood / Q000209:etiology* / Q000473:pathology
D006442:Glycated Hemoglobin