Research Project code：0350011227
Update date：Dec. 15, 2003
Diagnosis and treatment of stroke and neurological disorders: 3. Natural course of cardiogenic embolic stroke
2001 - 2002
Although health insurance does not cover yet in Japan, since a thrombolysis therapy by t-PA at an acute phase of cerebral infarction was approved in US, pathogenesis of cardiogenic infarction has been noticed. However, there have been many unknown points in pathogenesis and natural course of cardiogenic infarction. Thus, the clinical course and image diagnostic findings were analyzed for 30 cases (average 74 years old) with midbrain and cerebral artery horizontal part infarction due to cardiogenic infarction. Average 17 hours were required from the onset to hospitalization. The observing period was average 3.8 months after the onset. The exitus determined using Glasgow Outcome Scale was well-correlated with the infarction volume calculated from the CT image. That is, the average infarction volumes were 21.7+/-4.2 ml in the improved group, 94.2+/-53.4 ml in the slight dysfunction group, 131.0+/-113.2 ml in severe dysfunction group, 148.1 ml in chronic vegetable group and 274.2+/-8.5 ml in the death group. It was obvious that the larger the infarction volume is, the worse the exitus is. It was shown that when the infarction volume is more than 150 ml, the probability to be vegetable or dead is high. Natural reopen of the infracted vein was observed in 19 of 35cases (56.0%), and all the natural reopens were observed within 30 days after the onset. There was no significant difference in the average infarction volume between the cases with and without natural reopen. That is, it was shown that the reopen of the infarcted vein occurred at high rates in the natural course of cardiogenic infarction. It has been appealed that evaluation is necessary to be performed carefully for the reopen of the infarcted vein including thrombolysis therapy at the superacute phase.
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