This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yonemura, K. Articles by Yamaguchi, T. Search for Related Content PubMed PubMed Citation Articles by Yonemura, K. Articles by Yamaguchi, T. Pubmed/NCBI databases Medline Plus Health Information MRI Scans Related Collections Acute Cerebral Infarction Computerized tomography and Magnetic Resonance Imaging Pathology of Stroke

(Stroke. 2002;33:1541.)
© 2002 American Heart Association, Inc.

Original Contributions

Small Centrum Ovale Infarcts on Diffusion-Weighted Magnetic Resonance Imaging

Kiminobu Yonemura, MD; Kazumi Kimura, MD; Kazuo Minematsu, MD; Makoto Uchino, MD Takenori Yamaguchi, MD

From the Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, Osaka, and Department of Neurology, Kumamoto University School of Medicine, Kumamoto (M.U.), Japan.

Reprint requests to Kiminobu Yonemura, MD, Department of Medicine, National Kumamoto Hospital, 1-5 Ninomaru, Kumamoto 860-0008, Japan. E-mail kyonemu{at}aol.com

Background and Purpose— A small centrum ovale infarct (SCOI), caused by occlusion of the white matter medullary arteries, is often equated with a lacunar infarct. We sought to clarify the clinical characteristics of a SCOI visualized by diffusion-weighted MRI (DWI) compared with those of a small basal ganglia infarct (SBGI).

Methods— Patients with a SCOI (SCOI group; n=38) or SBGI (SBGI group; n=68) 15 mm in diameter on conventional MRI and DWI were selected from 582 consecutive patients with acute ischemic stroke. Sex, age, neurological symptoms, vascular risk factors, emboligenic heart disease, arterial occlusive disease in the ipsilateral carotid system, and recurrent stroke within the initial 30 days were compared between the 2 groups.

Results— Only 47% of SCOIs but 87% of SBGIs could be identified with the use of conventional MRI, whereas DWI could detect them all. Age, sex, and vascular risk factors were not significantly different between the 2 groups. The SCOI group had more frequently an abrupt onset of symptoms (63% versus 26%; P=0.0002), emboligenic heart diseases (34% versus 12%; P=0.0054), occlusive carotid and/or middle cerebral artery diseases (53% versus 19%; P=0.0004), and recurrent stroke (13% versus 1%; P=0.0216) but less frequently a classic lacunar syndrome (50% versus 81%; P=0.0009) than the SBGI group. On a multivariate analysis, both arterial and heart diseases were independently associated with the SCOI group.

Conclusions— Symptomatic SCOIs detected by DWI may be associated with large-vessel and heart diseases and should be distinguished from lacunar infarcts.

Key Words: cerebral arteries • heart disease • lacunar infarction • magnetic resonance imaging, diffusion-weighted

This article has been cited by other articles:

				N. Altaf, P. S. Morgan, A. Moody, S. T. MacSweeney, J. R. Gladman, and D. P. Auer Brain White Matter Hyperintensities Are Associated with Carotid Intraplaque Hemorrhage Radiology, July 1, 2008; 248(1): 202 - 209. [Abstract] [Full Text] [PDF]

				P H Lee, S H Oh, O Y Bang, I S Joo, and K Huh Pathogenesis of deep white matter medullary infarcts: a diffusion weighted magnetic resonance imaging study J. Neurol. Neurosurg. Psychiatry, December 1, 2005; 76(12): 1659 - 1663. [Abstract] [Full Text] [PDF]

				T Seifert, C Enzinger, M K Storch, G Pichler, K Niederkorn, and F Fazekas Acute small subcortical infarctions on diffusion weighted MRI: clinical presentation and aetiology J. Neurol. Neurosurg. Psychiatry, November 1, 2005; 76(11): 1520 - 1524. [Abstract] [Full Text] [PDF]

				M. Ouhlous, H. Z. Flach, T. T. de Weert, J. M. Hendriks, M. R. H. M. van Sambeek, D. W. J. Dippel, P. M. T. Pattynama, and A. van der Lugt Carotid Plaque Composition and Cerebral Infarction: MR Imaging Study AJNR Am. J. Neuroradiol., May 1, 2005; 26(5): 1044 - 1049. [Abstract] [Full Text] [PDF]

				P H Lee, S H Oh, O Y Bang, I S Joo, and K Huh Isolated middle cerebral artery disease: clinical and neuroradiological features depending on the pathogenesis J. Neurol. Neurosurg. Psychiatry, May 1, 2004; 75(5): 727 - 732. [Abstract] [Full Text] [PDF]

				P. H. Lee, S. -H. Oh, O. Y. Bang, S. -Y. Joo, I. S. Joo, and K. Huh Infarct patterns in atherosclerotic middle cerebral artery versus internal carotid artery disease Neurology, April 27, 2004; 62(8): 1291 - 1296. [Abstract] [Full Text] [PDF]

				P. H. Lee, O. Y. Bang, S. H. Oh, I. S. Joo, and K. Huh Subcortical White Matter Infarcts: Comparison of Superficial Perforating Artery and Internal Border-Zone Infarcts Using Diffusion-Weighted Magnetic Resonance Imaging Stroke, November 1, 2003; 34(11): 2630 - 2635. [Abstract] [Full Text] [PDF]

				V. W. Mark Callosal Neglect and Cognitive Impersistence Arch Neurol, October 1, 2003; 60(10): 1493 - 1494. [Full Text] [PDF]