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A method to distinguish the different etiological mechanisms of single subcortical infarction

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Abstract

Objectives

Although lenticulostriate artery (LSA) territorial infarcts usually appear as single subcortical infarctions (SSIs) on imaging, they are caused by various etiological mechanisms. We aimed to investigate the correlation between LSA morphology and the location or size of infarcts. Besides, we explored whether the location or size of infarcts can predict the presence of middle cerebral artery (MCA) plaques and distinguish the different etiological mechanisms of SSI patients.

Methods

We prospectively included patients with acute SSI in the LSA territory. The MCA plaques, infarct features, including the number of infarct slices, lowest infarct layer index (LILI), volume, maximum area and diameter, and LSA morphological characteristics, including the number of stems and branches, length, distance, and tortuosity were evaluated.

Results

A total of 105 patients were enrolled. Both the average length and average distance of LSAs were negatively correlated with the maximum infarct area (P=0.048, P=0.028, respectively) and maximum infarct diameter (P=0.016, P=0.010, respectively) on axial examination and were positively correlated with LILI (P=0.020, P=0.003, respectively). The number of LSA branches was associated with the number of infarct slices (P=0.040) and LILI (P=0.043). Moreover, we found that when the LILI=1 or 2 and the number of infarct slices ≥3, the SSI patients were more likely to have MCA plaques (P=0.045).

Conclusions

SSI patients with a LILI=1 or 2 and infarct slices of ≥3 were more likely to have MCA plaques. Our findings might provide a simple and feasible method to distinguish the different underlying mechanisms of SSIs for clinicians.

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Data availability

The data that support the findings of our study are available from the corresponding author upon reasonable request.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (Nos. 82071320 and 81870937) and the 1·3·5 project for disciplines of excellence, Clinical Research Incubation Project, West China Hospital, Sichuan University (No. 2020HXFH012).

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Author notes

  1. Tang Yang and Lu Tang contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Neurology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China

    Tang Yang, Shuai Jiang, Yuying Yan, Ye Yuan, Yi Hu & Bo Wu

  2. Department of Radiology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu, 610041, China

    Lu Tang & Jiayu Sun

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  1. Tang Yang
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  2. Lu Tang
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  5. Ye Yuan
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  8. Bo Wu
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Corresponding authors

Correspondence to Jiayu Sun or Bo Wu.

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This study was approved by the Ethics Committee of West China Hospital, and informed written consent was obtained from all patients.

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The authors declare no competing interests.

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Yang, T., Tang, L., Jiang, S. et al. A method to distinguish the different etiological mechanisms of single subcortical infarction. Neurol Sci 44, 1703–1708 (2023). https://doi.org/10.1007/s10072-023-06623-0

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