1997 Volume 19 Issue 4 Pages 294-300
We investigated the clinical characteristics of progressive stroke on admission. The subjects comprised 300 patients who were admitted on the day of onset of cerebral infarction in the territory of the internal carotid arteries and who showed a low density area on CT images within 5 days. These patients were treated with sodium ozagrel. Of the total of 300 patients, 221 had cerebral infarction in the territory of the deep perforate arteries, 56 had cerebral infarction in the territory of the cortical branch of the middle cerebral artery (MCA), and the remaining 23 demonstrated cerebral infarction throughout the MCA territory. The results obtained may be summarized as follows :
1) Progressive stroke was observed in a total or 29 (9.7%) of the patients, including 9 (4.1%) of the patients with infarction of the deep perforate arteries. 9 (14.8%) of the patients with infarction of the cortical branch of the MCA, and 11 (47.8%) of the patients with cerebral infarction throughout the MCA territory. Progressive stroke was seen significantly more frequently in patients with cerebral infarction throughout the MCA territory than in those with cerebral infarction of the deep perforate arteries (p<0.001; χ2 test). Similarly, progresive stroke was significantly more frequent in patients with cerebral infarction of the cortical branch of the MCA than in those with cerebral infarction of the deep perforate arteries (p<0.005; χ2 test).
2) All patients with progressive stroke demonstrated initial evidence of deterioration of their nearlogical deficits within 5 days after onset, with 13 patients showing deterioration on day 2 and patients showing deterioration on day 3. The maximal period from the beginning to end of such deterioration was 7 days.
3) progressive stroke was seen in only 29 (29.8%) of the 97 patients who were admitted with motor distrubances and unilateral negiect.
4) There was no significant incidence of progressive stroke among patients with atrial fibrillation (Af) on ECG.
5) Hemorrhagic infarction was observed in 14 (4.7%) of the patients, and there was no significant incidence of progressive stroke among these patients with hemorrhagic infarction.
6) Twenty-three (79.3%) of the 28 patients with progressive stroke showed severe motor impairment in the upper limbs.
In order to diagnose progressive stroke, therefore, it is useful to assess the motor disturbances and unilateral negleat.
