Abstract Details

Title Lesion Topography and Its Correlation with Etiology in Medullary Infarction: Analysis from a Multi-Center Stroke Study in China

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-064

Objective To clarify the lesion pattern of medullary infarction (MI) and to assess its correlation with stroke etiology.

Background The lesion topography of MI is heterogeneous and its correlation with stroke etiology remains elusive.

Design/Methods Of 1129 subjects with available DWI in SMART study (a multi-center trial concerning secondary stroke prevention in China) between April 2008 and December 2010, 43 patients with DWI confirmed MI (3.8%) were retrospectively evaluated. Lesions were categorized into lateral and medial medullary infarction (LMI and MMI, 33 and 10 subjects respectively) at 3 levels rostro-caudally and correlated with the stroke etiology. Clinical profiles and long-term prognosis were analyzed.

Results Large artery atherosclerosis, small vessel occlusion, cardiogenic embolism and artery dissection accounted for 29, 11, 1 and 2 infarcts respectively. Large artery disease was the most common cause in LMI (24 of 33, 72.7%) whereas small vessel occlusion was not uncommon in MMI (5 of 10, 50.0%). Though the difference of infarct pattern between large artery atherosclerosis and small vessel occlusion was insignificant, two distinct lesion patterns were considered to be relevant: (1) Rostral MMI with continuous medial pontine infarctions were more likely attributed to small vessel occlusion than large artery atherosclerosis. (2) MMI with ventral to dorsal extension were more often caused by large artery disease than small vessel occlusion. Median NIHSS at admission was 4. During a median follow-up of 17 months, 2 patients died and 2 experienced recurrent ischemic events, 39 of 41 subjects (95.1%) were functional independent (mRS 0-2).

Conclusions This multi-center study demonstrates that MI has distinct lesion pattern depending on various stroke etiologies and mechanisms. Future investigations with larger sample size should establish the lesion pattern of MI and validate its correlation with the stroke etiology and mechanisms, which might improve stroke management.

Authors/Disclosures
Yuehui Hong PRESENTER	Ms. Hong has nothing to disclose.
Lixin Zhou	Lixin Zhou has nothing to disclose.
Ming Yao	Ming Yao has nothing to disclose.
Yi-Cheng Zhu, MD, PhD (Peking Union Medical College Hospital)	Dr. Zhu has nothing to disclose.
Liying Cui, PhD (Peking Union Medical College Hospital)	No disclosure on file
Jun Ni	Jun Ni has nothing to disclose.
	No disclosure on file

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