지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
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Background: The ‘lacunar hypothesis’has been challenged since small (diameter <15 mm) subcortical infarctscan be produced by middle cerebral artery disease (MCAD) or cardioembolism (CE) while a larger infarct canoccur without evidence of MCAD or CE. We sought to assess whether lacunar hypothesis based on size criteriaonly is still valid. Methods: We studied 103 patients who 1) had acute (≤72 hours after onset), deep subcorticalMCA territory infarcts detected by diffusion-weighted MRI 2) underwent MR angiography. Stroke mechanismswere categorized as 1) MCAD when there was a corresponding MCA lesion, 2) CE when there was emboligenicheart disease without MCAD, and 3) small vessel disease (SVD) when there was neither CE nor MCAD. SVDwas further divided into definite SVD (dSVD, diameter <15 mm) or probable SVD (pSVD, diameter ≥15 mm).Results: Sixty-five patients (63%) had SVD (35 pSVD and 30 dSVD), 29 (28%) had MCAD, and nine (8.7 %)had CE. The diameter of infarcts was greater in CE than that of either MCAD (p<0.05) or SVD (p<0.01).Although it was greater in MCAD than in dSVD (p<0.01), but there was no difference in size between MCAD andpSVD (p=0.33) or MCAD and SVD (p=0.25). While patients with CE more often had cortical symptoms thanSVD (p<0.05) or MCAD+SVD (p<0.01), there was no difference in clinical features or risk factors betweenMCAD and SVD, and pSVD and dSVD. Conclusions: The deep subcortical infarcts associated with CE are dif-ferentiated from MCAD or SVD by the size and clinical features. However, there are no clinical diff e r e n c e sbetween MCAD and SVD, and pSVD and dSVD. There seems to be no rationale for 15 mm criteria for ‘lacunarinfarction’.
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