title: Estimation of stroke etiology from lesion patterns on diffusion-weighted magnetic resonance imaging in patients with carotid artery occlusive disease.
abstract: BACKGROUND
  Various mechanisms can be considered in ischemic stroke with internal carotid artery (ICA) occlusive diseases. We clarified the etiologic mechanisms from lesion patterns on diffusion-weighted imaging (DWI).
  
  
  METHODS
  One hundred and twenty consecutive ischemic stroke patients with ipsilateral ICA occlusive diseases were enrolled and classified into 3 groups according to the size of DWI lesions: group A, massive; group B, moderate-to-large; and group C, small. Group C was divided into 3 subgroups according to the number of lesions: C1, 1-3; C2, 4-9; and C3, 10 or more. The relationship between the DWI findings and stroke subtypes according to the TOAST classification was investigated.
  
  
  RESULTS
  Cardioembolism was significantly more common in groups A and B than in group C, while large-artery atherosclerosis (LAA) was more frequent in group C than in groups A and B. In group A, cardioembolism accounted for 32%, while LAA was not observed. Statistical analyses showed trends toward a higher frequency of LAA in groups C2 and C3 than in group C1.
  
  
  CONCLUSIONS
  Mechanisms of acute stroke in ICA diseases can be simply assessed from the lesion size and number, which may be useful in considering acute therapeutic strategies.
authors.affiliation: Stroke Center and Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.oyama@osaka-njm.net
authors.forename: Naoki
authors.initials: N
authors.lastname: Oyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Moriwaki
authors.forename: Naoaki
authors.initials: N
authors.lastname: Yamada
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nagatsuka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Naritomi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002340:Carotid Artery Diseases / Q000150:complications*; D002343:Carotid Artery, Internal / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000145:classification / Q000209:etiology* / Q000473:pathology*; D055815:Young Adult