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Prognosis of symptomatic and asymptomatic middle cerebral artery occlusion

Cited 5 time in Web of Science Cited 6 time in Scopus
Authors
Kang, Bong-Su; Kwon, Hyung-Min; Ryu, Wi-Sun; Lee, Yong-Seok
Issue Date
2008-09-24
Publisher
Karger
Citation
Cerebrovasc Dis. 2008;26(5):489-493
Keywords
AgedAged, 80 and overCardiovascular Diseases/*etiology/mortality/pathologyCerebral AngiographyFemaleHumansInfarction, Middle Cerebral Artery/*complications/mortality/pathologyIschemic Attack, Transient/etiologyKaplan-Meiers EstimateMagnetic Resonance AngiographyMaleMiddle AgedMyocardial Infarction/etiologyPrognosisRisk AssessmentStroke/etiologyTime FactorsUltrasonography, Doppler, Transcranial
Abstract
BACKGROUND: The annual risk of stroke or cardiovascular events has been reported to be over 10% in middle cerebral artery stenosis. However, the prognosis of patients with middle cerebral artery occlusion (MCAO) remains unclear. We investigated the risk of cardiovascular events or death in patients with symptomatic or asymptomatic MCAO. METHODS: Consecutive patients with MCAO demonstrated by transcranial Doppler sonography and magnetic resonance angiography were enrolled. Medical records were reviewed during the follow-up period and a telephone interview was conducted using a preformed questionnaire, comparing asymptomatic and symptomatic patients who had a history of ischemic stroke or transient ischemic attack in the same vascular territory. The composite outcome of ipsilateral stroke, hemorrhagic stroke, overall stroke, myocardial infarction (MI), any vascular death and nonvascular death was evaluated during the follow-up period. RESULTS: Thirty-seven of the 48 patients were symptomatic and 11 were asymptomatic. During the mean follow-up period of 2.8 years, cardiovascular events or death occurred in a total of 13 patients: 1 from the asymptomatic group and 12 from the symptomatic group (overall stroke, 6; MI, 2; vascular death, 1; nonvascular death, 5). The annual rates of composite outcome (2.2 vs. 13.2%, p = 0.041) and overall stroke (0.0 vs. 6.6%, p = 0.048) were significantly lower in the asymptomatic group. CONCLUSION: These results suggest that the overall prognosis of MCAO is not worse than previously reported for patients with middle cerebral artery stenosis or internal carotid artery stenosis. Asymptomatic MCAO seems to be a benign condition associated with a low risk of subsequent stroke, MI or death under the optimal medical therapy.
ISSN
1421-9786 (Electronic)
Language
English
URI
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=18810235

http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowPDF&ArtikelNr=000155986&Ausgabe=240331&ProduktNr=224153&filename=000155986.pdf

https://hdl.handle.net/10371/68384
DOI
https://doi.org/10.1159/000155986
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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