title: Predictors of clinical outcome in patients with acute perforating artery infarction.
abstract: OBJECTIVE
  We aimed to determine the predictive factors for super-acute perforating artery infarctions (PAI) involving lenticulostriate arteries infarctions (LSAI), anterior pontine arteries infarctions (APAI) and thalamic arteries infarctions (TAI). Whether intravenous thrombolysis (iv-tPA) therapy would influence the clinical outcome was also studied.
  
  
  METHODS
  We analyzed 84 consecutive patients within 12h of stroke symptom onset from January 2008 to June 2015. All patients had an imaging-proven acute infarction in the perforating territory of LSA (n=53), TA (n=21) and APA (n=10). Favorable clinical outcome was defined as modified Rankin Scale ≤1 at 90days. Patients were divided into groups according to clinical outcome, lesion location and thrombolysis therapy. Baseline demographic data, past medical history, National Institutes of Health Stroke Scale (NIHSS) score and infarction volume were compared between groups.
  
  
  RESULTS
  Eighty-four patients were recruited (median age: 61y; 67.9% male). All patients with TAI (n=21), 34/53 (64.2%) patients with LSAI and 4/10 (40%) patients with APAI achieved favorable clinical outcome (mRS≤1). Ninety-day clinical outcome was associated with age, previous stroke, baseline NIHSS, infarct location, infarct volume. Intravenous thrombolysis improved 24h NIHSS, but was not significantly associated with favorable outcome at 90days. In multivariate analysis, only previous stroke/TIA (OR 0.09, 95%CI 0.01-0.68, p=0.020) and infarct volume (OR 0.64, 95%CI 0.43-0.96, p=0.032) were independently associated with the outcome of acute PAI at 90days.
  
  
  CONCLUSIONS
  Previous stroke/TIA, infarct location and infarct volume were independently associated with the short-term clinical outcome of acute PAI.
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Lumeng
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China. Electronic address: wenjiecao@fudan.edu.cn.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Cao
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Wu
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Yifeng
authors.initials: Y
authors.lastname: Ling
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Cheng
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China; State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China. Electronic address: dongqiang2222@gmail.com.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Dong
mesh_terms: D000208:Acute Disease; D000368:Aged; D001488:Basilar Artery / Q000000981:diagnostic imaging; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D020521:Stroke / Q000150:complications* / Q000188:drug therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Clinical outcome; Locations; Perforating artery infarction; Thrombolysis