title: Lenticulostriate Artery Involvement is Predictive of Poor Outcomes in Superficial Middle Cerebral Artery Territory Infarction.
abstract: OBJECTIVE
  Patients with superficial middle cerebral artery (MCA) territory infarction may have concomitant lenticulostriate artery (LSA) territory infarction. We investigated the mechanisms thereof and the outcomes of patients with superficial MCA territory infarction according to the presence or absence of LSA involvement.
  
  
  METHODS
  Consecutive patients with first-ever infarction in the unilateral superficial MCA territory were included in this study. They were divided into the superficial MCA only (SM) group and the superficial MCA plus LSA (SM+L) group.
  
  
  RESULTS
  Of the 398 patients, 84 patients (21.1%) had LSA involvement (SM+L group). The SM+L group more frequently had significant stenosis of the proximal MCA or carotid artery and high-risk cardioembolic sources. Stroke severity and outcomes were remarkably different between the groups. The SM+L group showed more severe neurologic deficits (National Institute of Health Stroke Scale score 10.8±7.1 vs. 4.0±5.0, p<0.001) and larger infarct in the superficial MCA territory (40.8±62.6 cm³ vs. 10.8±21.8 cm³, p<0.001) than the SM group. A poor functional outcome (mRS >2) at 3 months was more common in the SM+L group (64.3% vs. 15.9%, p<0.001). During a mean follow-up of 26 months, 67 patients died. All-cause (hazard ratio, 2.246) and stroke (hazard ratio, 9.193) mortalities were higher in the SM+L group than the SM group. In multivariate analyses, LSA involvement was an independent predictor of poor functional outcomes and stroke mortality.
  
  
  CONCLUSIONS
  LSA territory involvement is predictive of poor long-term outcomes in patients with superficial MCA territory infarction.
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Kijeong
authors.initials: K
authors.lastname: Lee
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eun Hye
authors.initials: EH
authors.lastname: Kim
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dongbeom
authors.initials: D
authors.lastname: Song
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Kim
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hyo Suk
authors.initials: HS
authors.lastname: Nam
authors.affiliation: Department of Biostatistics, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hye Sun
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Department of Neurology, Severance Stroke Center, Yonsei University College of Medicine, Seoul, Korea. jhheo@yuhs.ac.
authors.forename: Ji Hoe
authors.initials: JH
authors.lastname: Heo
mesh_terms: D016893:Carotid Stenosis / Q000401:mortality / Q000473:pathology; D003251:Constriction, Pathologic / Q000473:pathology; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000401:mortality / Q000473:pathology*; D008297:Male; D020768:Middle Cerebral Artery / Q000473:pathology*; D015999:Multivariate Analysis; D012720:Severity of Illness Index; D020521:Stroke / Q000401:mortality / Q000473:pathology
keywords: Lenticulostriate artery; cerebral infarction; middle cerebral artery; mortality; prognosis