Lesion Location Predicts Early Neurological Deterioration in Single Subcortical Infarction

Abstract

Background: A certain number of patients with single subcortical small infarction (SSSI) in the lenticulostriate artery (LSA) territory present with early neurological deterioration (END).

Objective: We sought to identify a more specific predicting imaging marker for END in lenticulostriate SSSI patients.

Methods: We screened patients in a prospective hospital-based registry of stroke in the first Affiliated Hospital of Zhengzhou University from January 2015 to December 2020. Lesion locations were defined as posterior type when more than half of the lesion was located in the posterior part of the corona radiata divided by the midline, which was drawn between the tangents of the anterior and posterior horns of the lateral ventricle and was adjacent to the lateral ventricle at the same time. END was defined as an increase of ≥2 points in total National Institutes of Health Stroke Scale score or ≥1 point. A multivariate logistic analysis was used to assess the imaging predictors for END.

Results: 418 patients were enrolled in the final data analysis. Among them, 206 (49. 3%) cases were rated as the posterior type and71 (17.0%) cases had to END. A multivariate logistic analysis showed that only the posterior type (adjusted odds ratio, 2. 126; 95% confidence interval, 1. 250-3. 614; P = 0. 005) was independently associated with the risk of END.

Conclusion: The posterior type of lesion location represented an imaging marker predicting END in lenticulostriate SSSI patients.

Keywords: Single small subcortical infarction; corticospinal tract; early neurological deterioration; lenticulostriate artery territory; lesion location; the posterior type..