title: Clinical correlates of infarct shape and volume in lacunar strokes: the Secondary Prevention of Small Subcortical Strokes trial.
abstract: OBJECTIVE
  Infarct size and location are thought to correlate with different mechanisms of lacunar infarcts. We examined the relationship between the size and shape of lacunar infarcts and vascular risk factors and outcomes.
  
  
  METHODS
  We studied 1679 participants in the Secondary Prevention of Small Subcortical Stroke trial with a lacunar infarct visualized on diffusion-weighted imaging. Infarct volume was measured planimetrically, and shape was classified based on visual analysis after 3-dimensional reconstruction of axial MRI slices.
  
  
  RESULTS
  Infarct shape was ovoid/spheroid in 63%, slab in 12%, stick in 7%, and multicomponent in 17%. Median infarct volume was smallest in ovoid/spheroid relative to other shapes: 0.46, 0.65, 0.54, and 0.90 mL, respectively (P<0.001). Distributions of vascular risk factors were similar across the 4 groups except that patients in the ovoid/spheroid and stick groups were more often diabetic and those with multicomponent had significantly higher blood pressure at study entry. Intracranial stenosis did not differ among groups (P=0.2). Infarct volume was not associated with vascular risk factors. Increased volume was associated with worse functional status at baseline and 3 months. Overall, 162 recurrent strokes occurred during an average of 3.4 years of follow-up with no difference in recurrent ischemic stroke rate by shape or volume.
  
  
  CONCLUSIONS
  In patients with recent lacunar stroke, vascular risk factor profile was similar among the different infarct shapes and sizes. Infarct size correlated with worse short-term functional outcome. Neither shape nor volume was predictive of stroke recurrence.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT00059306.
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.).
authors.forename: Negar
authors.initials: N
authors.lastname: Asdaghi
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.).
authors.forename: Lesly A
authors.initials: LA
authors.lastname: Pearce
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.).
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakajima
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.).
authors.forename: Thalia S
authors.initials: TS
authors.lastname: Field
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.).
authors.forename: Carlos
authors.initials: C
authors.lastname: Bazan
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.).
authors.forename: Franco
authors.initials: F
authors.lastname: Cermeno
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.).
authors.forename: Leslie A
authors.initials: LA
authors.lastname: McClure
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.).
authors.forename: David C
authors.initials: DC
authors.lastname: Anderson
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.).
authors.forename: Robert G
authors.initials: RG
authors.lastname: Hart
authors.affiliation: From the Division of Neurology, Department of Medicine, Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada (N.A., M.N., T.S.F., F.C., O.R.B.); Biostatistics Consultant, Minot, ND (L.A.P.); Department of Radiology, University of Texas Health Sciences Centre, San Antonio (C.B.); Department of Biostatistics, University of Alabama at Birmingham (L.A.M.); Department of Neurology, Hennepin County Medical Center and the University of Minnesota, Minneapolis (D.C.A.); Division of Neurology, Department of Medicine, McMaster University, Hamilton, Ontatio, Canada (R.G.H.); SPS3 Coordinating Center (N.A., L.A.P., M.N., T.S.F., C.B., F.C., R.G.H., O.R.B.); and SPS3 Statistical Center (L.A.M.). Oscar.benavente@ubc.ca.
authors.forename: Oscar R
authors.initials: OR
authors.lastname: Benavente
mesh_terms: D000368:Aged; D002544:Cerebral Infarction / Q000150:complications / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D020127:Recovery of Function; D012008:Recurrence; D055502:Secondary Prevention; D059409:Stroke, Lacunar / Q000473:pathology* / Q000517:prevention & control
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: diffusion imaging weighted; lacunar infarct; shape; stroke; volume