スダ　サトシ   SUDA Satoshi   須田　智    所属   埼玉医科大学  医学部 国際医療センター　神経内科・脳卒中内科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	Characteristics of subcortical infarction due to distal MCA penetrating artery occlusion
掲載誌名	正式名：JOURNAL OF THE NEUROLOGICAL SCIENCES ISSNコード：0022-510X/1878-5883
出版社	ELSEVIER SCIENCE BV
巻・号・頁	368,160-164頁
著者・共著者	Kentaro Suzuki,Junya Aoki,Yoshio Tanizaki,Yuki Sakamoto,Satoshi Takahashi,Arata Abe,Hiroaki Kimura,Tadashige Kano,Satoshi Suda,Yasuhiro Nishiyama,Kazunori Akaji,Ban Mihara,Kazumi Kimura
発行年月	2016/09
概要	Objective: Isolated deep subcortical infarcts develop as a result of occlusion of the penetrating arteries from the internal carotid artery (ICA) and the proximal (M1) and distal middle cerebral artery (MCA). However, the clinical and neuroimaging characteristics of infarcts due to the occlusion of the distal MCA penetrating artery are unclear. Methods: Consecutive patients with ischemic stroke or transient ischemic attack with magnetic resonance imaging (MRI) performed within 2 days of onset were studied retrospectively. Using coronal MRI data, isolated deep subcortical infarcts were classified into two groups: 1) proximal group, described as being longer than they are wide, which were expected to be related to the occlusion of the ICA or M1 penetrating artery; and 2) distal group, described as oblong, which were expected to be associated with the occlusion of penetrating arteries from the distal MCA (M2/M3/M4). Results: A total of 653 consecutive acute ischemic stroke patients (proximal group, 50 [7.7%]; distal group, 14 [2.1%]) were enrolled. Baseline clinical characteristics were not different between the 2 groups. Modified Rankin Scale scores were lower in the distal group than in the proximal group 3 months after stroke onset (1.43 +/- 0.36 vs. 226 +/- 1.35, p = 0.023). We measured the lengths of the infarcts in the X and Y directions using axial MRI. The X/Y ratio was larger in tile distal group than in the proximal group (1.3 +/- 0.6 vs. 0.7 +/- 02, p < 0.01), which indicated that distal MCA penetrating artery infarcts appear more oblong on axial MRI. Conclusions: One cause for deep subcortical infarction is the occlusion of the distal MCA penetrating arteries, which occurs in 22% of patients with deep subcortical infarctions. These patients had better clinical outcomes than those with ICA and M1 penetrating artery infarctions. Distal MCA penetrating artery infarctions appear oblong on axial MRI. (C) 2016 Elsevier B.V. All rights reserved.
DOI	10.1016/j.jns.2016.07.005
PMID	27538623