Acute Cerebral Infarction Symptoms, The Relationship Between The Classification And Radiological Classification And Etiology

Objective - The aim of this study was to correlate with symptomatic, radiological and etiological diagnosis in acute ischemic stroke. Subjects and methods - one hundred and twenty-five patients with ischemic stroke within 48 hour of onset were prospectively studied with three-step diagnosis: 1) symptomatic diagnosis based on the Oxfordshire Community Stroke Project criteria (OCSP), 2) radiological diagnosis (CT or MRI) and 3) etiological diagnosis based on the Lausanne Stroke Registry criteria. Results - Most of the patients with symptoms of total anterior circulation infarcts (TACI), partial anterior circulation infarcts (PACI) and posterior circulation infarcts (POCI) had corresponding lesions on CT or MRI, while only 67.3% of lacunar infarcts (LACI) patients had small subcortical infarction (SSI). More than 60% of patients with TACI were classified into cardioembolism (CE) in the third diagnosis, while the etiology of PACI was either CE or large-artery atherosclerosis (LAA) in equal numbers. Only 57.7% of LACI patients were classified into small-artery disease (SAD) and 28.8% of them into LAA, of which 80% patients had lesions other than SSI. The positive predictive value of SAD in the combination of LACI and SSI was 0.78. The etiology of POCI was variable. Conclusion - Except for LACI, the symptomatic classification by OCSP corresponds well to the radiological diagnosis. The etiological diagnosis can be predicted by OCSP in TACI and PACI, but it is hard in POCI, and a number of LACI are due to LAA.