The Study Of Clinical、imagine Characteristics And Its Etiology Of Single Infarction Located In Basal Ganglia Region

Objective:Compare the clinical and imaging characteristics of single cerebral infarction with various diameters in basal ganglia region,and to explore the possible mechanism of vascular etiology.Methods:All 246 patients with single acute infarction in basal ganglia region of 48 h who were hospitalized in Department of Neurology of Affiliated Hospital of Qingdao University during December 2014 to December 2016 were recruited into this study.All patients had magnetic resonance imaging(MRI),brain and neck CTA and / or digital subtraction angiography(DSA)were performed within the onset of 72 h.According to the diffusion weighted imaging(DWI)on the maximum diameter of infarction were divided into two groups:(1)Lacunar Infarcts,LI;n=140,maximal diameters<20mm;(2)Striatocapsular Infarction,SCI;n=106,maximal diameters>20mm.Each group was divided into four subgroups according to the clinical and imaging characteristics,to investigate the stroke mechanism.Results:1.Clinical features:The most common lacunar syndrome in LI group was pure motor hemiparesis(PMH)(66/140,47.1%)and dysarthria-clumsy hand syndrome(DCHS)(52/140,37.1%).There were 10 progression cases(10/140,7.1%).53 patients(53/106,50%)had cortical symptoms in SCI,aphasia(36/53,67.9%)is one of the most common feature.There were 63 cases of hemiplegia symptoms,of which,43 cases(43/63,68.3%)showed unequal paralysis.There were 29 progression cases(29/106,27.4%).Compared the two groups of disease changes within 7d after admission was statistical significance(X=-18.511,P< 0.05).2.Analysis of risk factors for the progression of 7d in two groups after admission:Admission 1d NIHSS score(t =-4.818,P = 0)was a risk factor for early progression in SCI.3.Comparative analysis of vascular etiologies:58 patients(58/140,41.4%)had relevant intracranial large artery disease in LI,39 cases of middle cerebral artery(MCA)lesions,19 cases of intracranial internal carotid artery(ICA),1 case of extracranial ICA lesions;81 cases of small vessel diseases.Compared vascular stenosis between MCA and ICA in LI was no statistical significance(X2=-1.013,P>0.05).68 patients(68/106,64.2%)had relevant intracranial large artery disease in SCI,45 cases of MCA lesions,23 cases of ICA lesions,1 case of extracranial ICA lesions;37 cases of small vessel diseases.Compared vascular stenosis between MCA and ICA in SCI was no statistical significance(X2=0.259,P>0.05).Compared vascular stenosis and diameters of the infarction in SCI was statistical significance(t=-2.456,P < 0.05).The proportion of the patients with intracranial large vascular lesions in SCI was significantly higher than in LI(X2=-12.710,P < 0.05).Compared vascular stenosis of two groups was no statistical significance(X2=-0.942,P > 0.05).Conclusion:1.Two group had different clinical features:The most common lacunar syndrome in LI group was PMH and DCHS.Patients in SCI revealed all kinds of cortical symptoms,aphasia is one of the most common feature.Patients in SCI tended to progression disease.2.Admission NIHSS score is a risk factor for progression in SCI.3.Two groups of vascular etiology:The formation mechanism of the two groups was related to the ipsilateral large and small vascular disease.The LI group was mainly associated with ipsilateral small vessel disease;SCI was mainly associated with ipsilateral intracranial large vascular disease.