title: The Development of Cortical Microinfarcts Is Associated with Intracranial Atherosclerosis: Data from the Chinese Intracranial Atherosclerosis Study.
abstract: BACKGROUND
  Little is known about the association between the cortical microinfarcts (CMIs) and intracranial atherosclerosis (ICAS) in Chinese patients with ischemic stroke. This study was designed to analyze the association and evaluate the role of CMIs in clinical outcomes.
  
  
  METHODS
  We evaluated 1421 consecutive patients who had experienced an acute cerebral ischemia within 7 days after symptom onset and evaluated the presence of CMIs and ICAS based on patients' 3.0-T magnetic resonance imaging and magnetic resonance angiography scans. Baseline characteristics, patient risk factors, and clinical outcomes were analyzed to investigate the different outcomes between the CMIs (n = 209) group and non-CMIs (n = 1212) group.
  
  
  RESULTS
  CMIs were present in 14.7% persons. The following parameters were associated with risk of CMIs: advanced age, National Institutes of Health Stroke Scale score on admission, lower level of systemic blood pressure, lower triglycerides level, ICAS, and cerebral microbleeds (CMBs). On multivariate logistic regression analysis, ICAS remained an independent risk factor for the development of CMIs (adjusted odds ratio, 1.493; 95% confidence interval, 1.022-2.182; P = .038). At the time point of 1 year after stroke, the rates of poor outcome (modified Rankin Scale, 3-6) in CMIs group (33.5%) were statistically significantly different from the non-CMIs group (22.6%; P = .001). In addition, patients in CMIs group had a significantly higher stroke recurrence rate than patients in the non-CMIs group (6.7% versus 4%; P = .085).
  
  
  CONCLUSIONS
  The development of CMIs is strongly associated with ICAS. CMIs are independent predictors of poor prognosis in patients with ischemic stroke.
authors.affiliation: Department of Neurology, Beijing Shi Ji Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Fu
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China. Electronic address: yongjunwang1962@gmail.com.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of INI Stroke Center and Stroke Network, OSF Healthcare System, University of Illinois College of Medicine, Peoria, Illinois.
authors.forename: David Z
authors.initials: DZ
authors.lastname: Wang
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuesong
authors.initials: Y
authors.lastname: Pan
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuehua
authors.initials: Y
authors.lastname: Pu
authors.affiliation: Department of Neurology, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Changqing
authors.initials: C
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications; D002544:Cerebral Infarction / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D002537:Intracranial Arteriosclerosis / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000209:etiology; D055815:Young Adult
keywords: Cortical microinfarcts; intracranial atherosclerosis; ischemic; stroke