title: Features of brain magnetic resonance imaging diffusion-weighted images of aortogenic embolic stroke.
abstract: BACKGROUND
  The features of acute aortogenic embolic stroke on magnetic resonance diffusion-weighted imaging (DWI) have not been fully elucidated, so we compared patients with acute aortogenic embolic stroke and those with acute cardioembolic stroke.
  
  
  RESULTS
  This study included 40 consecutive patients with acute aortogenic embolic stroke, and 40 age- and sex-matched patients with acute cardioembolic stroke. The diagnosis of aortogenic embolic stroke was made when patients met 5 criteria: (1)acute neurologic event lasting >24h; (2) positive signals on DWI; (3) atherosclerotic lesions ≥3.5-mm thick at the aortic arch on transesophageal echocardiography; (4) neuroradiologic features suggesting embolic stroke, such as lesions involving the brain cortex or the re-opening phenomenon of previously occluded vessels on Magnetic Resonance Angiography (MRA); and (5) absence of other embolic sources, including heart disease and carotid stenosis. The number, site, and maximal diameter of the infarct lesions on DWI were compared between the aortogenic and cardiogenic groups. The aortogenic patients more frequently had ≥3 lesions (25.0% vs. 2.5%, P<0.01), lesions with a maximal diameter <30mm (77.5% vs. 20.0%, P< 0.001), and vertebrobasilar system lesions (55.0% vs. 10.0%, P< 0.001) than the cardiogenic patients.
  
  
  CONCLUSIONS
  Acute aortogenic embolic stroke is characterized by multiple (≥3) and small lesions, and involvement of the vertebrobasilar system.
authors.affiliation: Department of Cerebrovascular Medicine and Neurology, Cerebrovascular Center and Clinical Research Institute, National Hospital Organization Kyushu Medical Center.
authors.forename: Jun-Ichiro
authors.initials: J
authors.lastname: Shimada
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yasaka
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Wakugawa
authors.forename: Toshiyasu
authors.initials: T
authors.lastname: Ogata
authors.forename: Noriko
authors.initials: N
authors.lastname: Makihara
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ito
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kuwabara
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000000981:diagnostic imaging* / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008297:Male; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology