Abstract W MP67: Etiology-Specific Clinical and Imaging Features in Ischemic Stroke
Background: Identification of clinical and imaging characteristics of ischemic stroke that can predict the underlying etiology is critical for accurate stroke subtyping. We sought to investigate the relationship between stroke characteristics and stroke etiology in 7,591 patients in the NINDS Stroke Genetics Network Study.
Methods: We determined the probability of having a major etiology in the presence of certain stroke characteristics that were previously linked to specific stroke mechanisms. We excluded patients with multiple competing major etiologies. All patients had brain imaging, intra- and extra-cranial vascular imaging, and complete cardiac assessment. We defined major etiologies according to the Causative Classification of Stroke System Criteria without reference to the stroke characteristics under study.
Results: History of 1 ipsilateral ischemic events within the last month, the presence of internal watershed infarcts or multiple, ipsilateral, unilateral, and temporally separate infarcts were associated with large artery atherosclerosis (Table). Multiple acute infarcts in different cerebral circulations were more common in patients with major cardiac source of embolism as well as in those with uncommon/cryptogenic causes. Stereotypic lacunar TIAs within the last week and lacunar syndrome were associated with lacunar infarction
Discussion: Clinical and imaging stroke characteristics appear to predict stroke etiologies. This information may find utility in developing algorithms for a guided stroke evaluation as well as help identify the most likely causative etiology in the presence of multiple competing etiologies.
Author Disclosures: E. Arsava: None. R.D. Brown: None. S.J. Kittner: Research Grant; Significant; NIH grant U01-NS069208. J.F. Meschia: Consultant/Advisory Board; Modest; CREST Executive Committee membership. Other; Modest; SiGN Co-PI. B.D. Mitchell: None. K.M. Rexrode: None. J. Rosand: Research Grant; Significant; NIH grants P50-NS051343, R01-NS059727, R01-NS073344. T. Rundek: Research Grant; Significant; NIH grants K24-NS062737, R01-NS065114. D. Woo: Research Grant; Significant; NIH grants R01-NS036695, U01-NS069208. B.B. Worrall: Employment; Modest; associate editorship for Neurology. Research Grant; Significant; NIH grant U01-NS069208. Other; Modest; SiGN and GARNET. H. Ay: Research Grant; Significant; NIH grant R01-NS059710. Ownership Interest; Modest; developer of the classification system used in the study.
- © 2014 by American Heart Association, Inc.