Infarcts with a Cardiac Source of Embolism in the NINCDS Stroke Data Bank: Historical Features

To Gain Insight into the Historical Features Relevant to the Diagnosis of Cardiac Embolic Strokes, We Studied the 1,290 Patients with Cerebral Infarcts in the NINCDS Stroke Data Bank. based Solely on the Presence of Cardiac Sources of Embolism, We Divided the Patients into Groups of High (N = 250), Medium (N = 166), and Low (N = 874) Risk of a Cardiogenic Mechanism for their Stroke. There Was a Highly Significant Graded Relationship between Increasing Risk of a Cardiac Source and a History, or Presence Of, Systemic Embolism, Abrupt Onset, and Diminished Level of Consciousness at Onset. These Clinical Features May Be Useful for Assessing the Likelihood of a Cardiac Embolic Mechanism in Patients with Cerebral Infarcts. © 1990 American Academy of Neurology

Features on Initial Computed Tomography Scan of Infarcts with a Cardiac Source of Embolism in the Ninds Stroke Data Bank

Background and Purpose: The Lack of Valid Criteria for the Clinical Diagnosis of Cardiogenic Embolism is a Major Problem in Both Patient Care and Research. the Aim of This Study Was to Identify Features on the Initial Computed Tomogram of the Brain that Discriminate between Patient Groups with and Without a Cardiac Source of Embolism. to Gain Insight into the Neuroradiological Features Relevant to the Diagnosis of Cardiac Embolic Stroke, We Studied the Initial Computed Tomogram of the 1,267 Patients with Ischemic Stroke and Such a Scan in the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Data Bank. Methods: We Analyzed the Initial Computed Tomographic Data from 1,267 Patients with Ischemic Stroke in the NINDS Stroke Data Bank. based Solely on the Presence of Cardiac Sources of Embolism, We Defined Groups with High (N=244), Medium (N=165), and Low (N=858) Risk for Cardiogenic Embolism and Compared the Features on the Initial Computed Tomogram among These Three Groups. Results: Patients in the High-Risk Group Were Significantly MCirc Likely (P\u3c0.001) to Have Infarcts Involving One Half Lobe or Larger or Infarcts Involving Both Superficial and Deep Structures Than Patients in the Medium- or Low-Risk Groups. in Contrast, Deep Small Infarcts Had a Negative Association (P=0.004) with the Presence of a Cardiac Source of Embolism. There Was No Significant Trend Across Risk Groups in the Percent with Hemorrhagic Infarction, Regardless of Whether Patients with Anticoagulant Use at the Time of the Stroke Were Excluded. Conclusion: Although Some Features of the Initial Computed Tomogram Had Highly Significa Nt Associations with the Presence of a Cardiac Source of Embolism, the Predictive Value of These Features for an Embolic Source Was Low. © 1992 American Heart Association, Inc

Infarcts with a Cardiac Source of Embolism in the NINDS Stroke Data Bank: Neurologic Examination

To Gain Insight into Neurologic Signs Relevant to the Diagnosis of Cardiogenic Embolism, We Analyzed Data from 1,290 Patients with Cerebral Infarcts in the NINDS Stroke Data Bank. based Solely on the Presence of Potential Cardiac Sources of Embolism, We Divided Patients into Groups of High (N = 250), Medium (N = 167), and Low (N = 873) Risk of a Cardiogenic Mechanism for their Stroke. Diminished Level of Consciousness Was Highly Associated with the Presence of a Cardiac Source of Embolism. of the Four Primarily Cortical Deficits Assessed, Three (Visual Field Abnormalities, Neglect, and Aphasia) Showed a Highly Significant Graded Relationship to the Cardiac Risk Groups. for the Fourth Cortical Deficit (Other Nonlanguage Cognitive Functions), This Relationship Did Not Attain Statistical Significance. Conversely, Hemiparesis Without Sensory or Cortical Deficits Had a Strong Inverse Association to the Presence of a Cardiac Source of Embolism. This Inverse Association Was Weaker for Sensorimotor Strokes and Nonexistent for Pure Sensory Strokes. Although Some Neurologic Findings Had Highly Significant Associations with the Presence of a Cardiac Source of Embolism, their Predictive Value for an Embolic Source Was Low. © 1992 American Academy of Neurology