Predictors Of Progressive Motor Deficits After Supratentorial Subcortical Infarcts

Objective To investigate the related predictors of progressive motor deficits (PMD)after supratentorial subcortical infarcts, so as to provide the scientific evidence on theassessment of PMD.Methods A total of142patients with supratentorial subcortical infarction wereenrolled prospectively． They were divided into either a PMD group or a stable groupaccording to the disease characteristics and the motor scores of the National Institutes ofHealth Stroke Scale (NIHSS)．The general clinical data，laboratory parameters，neurological score，and imaging characteristics were compared between the twogroups． The logistic regression analysis was used to analyze the independent riskfactor for supratentorial subcortical infarcts with PMD．Results1. Of the142patients with supratentorial subcortical infarcts，39(27.5%)were in the PMD group． The mean time of progression was30±11hours，and theprogression in33patients (84.6%) was during the night．2. Univariate analysis revealed that the proportions of female (P=0.045)，baselinesystolic blood pressure (SBP)≥180mm Hg (P=0.000)，corona radiata infarction (P=0.000)，diameter of infarction15～30mm (P=0.003)，unstable plaque in carotidartery(P=0.001)，and patients with middle cerebral artery stenosis or occlusion (P=0.015) in the PMD group were significantly higher than those in the stable group; whilethe proportions of the basal ganglia infarction (P=0.000) and infarct diameter＜15mm (P=0.000) in the stable group were significantly higher than those in the PMD group．3. Multivariate Logistic regression analysis showed that female (OR，2.837，95%CI1.076～7.485; P=0.035)，baseline SBP≥180mm Hg (OR，3.509，95%CI1.349～9.124; P=0.010)，corona radiata infarction (OR，6.807，95%CI2.446～18.944; P=0.000)，unstable plaque in carotid artery (OR，3.137，95%CI1.019～9.657; P=0.046)，and middle cerebral artery lesions (OR，4.027，95%CI1.160～13.976; P=0.028) were the independent risk factors for PMD．Conclusion The incidence of PMD in patients with supratentorial subcortical infarctsis higher． Female sex，baseline SBP≥180mm Hg，corona radiata infarction，unstableplaque in carotid artery，and middle cerebral artery lesions are the important predictorsof PMD．...