Research Project code：0450021008
Update date：Dec. 15, 2003
Diagnosis and treatment of stroke and neurological disorders: Embolic mechanism as a possible cause of simultaneous small infarcts in multiple vascular territories
2002 - 0
Investigating Researcher (1)：
Popularization of MRI diffusion weighted images (MR-DWI) made exact detection of fresh infarction possible and freshly scattered small infarctions in plural blood vessel dominating area are often experienced. Sooner elucidation of their underground pathological features is desired. Small infarctions or lacunar infarctions are considered as a so-called small artery disease developed by occlusion of deep perforating branch and about 10% of the disease might be caused by embolic mechanism. These simultaneous multiple small infarctions may be participated by the embolic mechanism. Sources of embolism were searched by MRA, cerebral angiography, Holter electrocardiogram, transesophageal echocardiography (TEE), and the like for 26 cases of scattered fresh small infarctions in plural blood vessel dominating area with MR-DWI. The results suspected embolism as a source in 17 cases (65.4%). That is, cardiogenic embolism such as atrial fibrillation or left atrial thrombosis was strongly suspected in 12 cases and large artery disease such as stenoses of bilateral mesocephalic and cerebric arteries, and basilar artery became clear in 7 cases. Unilateral lesion of large artery was clearly found in 3 cases. Probable artery originated cerebral embolism is suspected in these cases. No active finding of embolic mechanism was found in 6 cases. Suspected sources of embolism at a high rate of 65.4% suggest necessity to suspect embolic mechanism under the background of simultaneous multiple small infarctions.
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