단독 전대뇌동맥 뇌경색의 예후와 예후인자

Abstract

Background: Isolated anterior cerebral artery (ACA) territory infarction is uncommon and there have been no prospective out-come studies in Korea. Methods: From September 2004 to August 2005, patients with isolated ACA territory infarction ad-mitted within 7 days of symptom onset from 4 university hospitals were collected prospectively. We analyzed clinical and lab-oratory characteristics, stroke subtypes, stroke severity, and medical complications by a predetermined protocol. The out-come was measured by the modified Rankin Scale (mRS) at 3-months after stroke onset and classified as good (mRS score of 0 to 3) or poor (mRS score of 4 to 6) outcome. Results: Thirty-seven (2.9%) patients were identified to have isolated ACA ter-ritory infarction among 1,254 patients with acute ischemic stroke. Mean age was 67 years (range 45 to 83) and female were 22 (59%). Stroke subtypes were large-artery atherosclerosis in 57%, cardioembolism in 22%, undetermined in 19%, and small-vessel occlusion in 3%. The median National Institutes of Health Stroke Scale (NIHSS) score at admission was 4 (range 0 to 28). Neurological progression was developed in 9 patients (24%) and medical complications in 13 patients (35%). At 3 months after the stroke onset, 27 patients (72%) showed good outcome and 10 patients (27%) showed poor outcome. On univariate a-nalysis, medical complication, and NIHSS scores at admission were significantly associated with good outcome. Multivar-iate analysis revealed NIHSS scores at admission was independent predictor of functional outcome at 3 months. Conclusion: The overall prognosis of isolated ACA infarction was favorable and NIHSS scores at admission were important prognostic factor. (Korean J Stroke 2009;11:19-24)