Imaging patterns and prognosis of proximal and distal small subcortical infarcts.
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| Title: | Imaging patterns and prognosis of proximal and distal small subcortical infarcts. |
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| Authors: | Mombelli, Stefano (AUTHOR), Rinaldi, Chiara (AUTHOR), Palumbo, Vanessa (AUTHOR), Poggesi, Anna (AUTHOR), Nencini, Patrizia (AUTHOR), Vandelli, Gabriele (AUTHOR), Busto, Giorgio (AUTHOR), Pascarella, Rosario (AUTHOR), Fainardi, Enrico (AUTHOR), Zedde, Maria Luisa (AUTHOR), Arba, Francesco (AUTHOR) |
| Source: | Neurological Sciences. Aug2025, Vol. 46 Issue 8, p3709-3717. 9p. |
| Subjects: | Cerebral small vessel diseases, Medical sciences, Length of stay in hospitals, Clinical deterioration, Logistic regression analysis |
| Abstract: | Introduction: Small subcortical infarcts (SSI) are one of the hallmarks of cerebral small vessel disease and have been classified in two different imaging patterns: proximal-SSI (p-SSI) and distal-SSI (d-SSI), according to the shape, size and location to the parent artery. We aimed to investigate imaging and prognosis differences between p-SSI and d-SSI. Methods: We retrospectively reviewed records of consecutive patients with SSI admitted at two Stroke Units. We assessed location, shape and axial diameter of p-SSI and d-SSI with computed tomography (CT) and/or magnetic resonance (MR) imaging blinded to clinical data. Outcomes were: Early Neurological Deterioration (END), length of hospital stay, rehabilitation after discharge and functional status at 3 months assessed with modified Rankin Scale (mRS). We assessed independent associations between type of subcortical stroke and outcomes with logistic and ordinal regression analysis. Results: We included 292 patients, mean (+ -SD) age 67.42 (+ -12.41) years, 205 (70%) males, median (IQR) NIHSS = 4 (2–5); END occurred in 57 (20%) patients. Compared with d-SSI, p-SSI was associated with non-rounded shape (82%vs 65%,p = 0.005), lesion diameter > 15 mm (34% vs 10%,p < 0.001), infratentorial location (39% vs 23%,p = 0.005), absence of white matter changes (22% vs 12%,p = 0.035). END occurred more frequently in p-SSI (44% vs 10%,p < 0.001; OR = 7.23;95%CI = 3.73–14.03). In p-SSI, length of hospital stay was more frequently longer than six days (58% vs 40%,p = 0.005; OR = 1.78;95%CI = 1.04–3.07) and a shift towards worse mRS (cOR = 2.47;95%CI = 1.46–4.18) was observed. Conclusions: d-SSI and p-SSI have different imaging and prognostic characteristics that may suggest a distinct etiological origin and possibly different therapeutic approach. [ABSTRACT FROM AUTHOR] |
| Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Psychology and Behavioral Sciences Collection |
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| Header | DbId: pbh DbLabel: Psychology and Behavioral Sciences Collection An: 186678245 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Imaging patterns and prognosis of proximal and distal small subcortical infarcts. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Mombelli%2C+Stefano%22">Mombelli, Stefano</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rinaldi%2C+Chiara%22">Rinaldi, Chiara</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Palumbo%2C+Vanessa%22">Palumbo, Vanessa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Poggesi%2C+Anna%22">Poggesi, Anna</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Nencini%2C+Patrizia%22">Nencini, Patrizia</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Vandelli%2C+Gabriele%22">Vandelli, Gabriele</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Busto%2C+Giorgio%22">Busto, Giorgio</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pascarella%2C+Rosario%22">Pascarella, Rosario</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fainardi%2C+Enrico%22">Fainardi, Enrico</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zedde%2C+Maria+Luisa%22">Zedde, Maria Luisa</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Arba%2C+Francesco%22">Arba, Francesco</searchLink> (AUTHOR) – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Neurological+Sciences%22">Neurological Sciences</searchLink>. Aug2025, Vol. 46 Issue 8, p3709-3717. 9p. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Cerebral+small+vessel+diseases%22">Cerebral small vessel diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+sciences%22">Medical sciences</searchLink><br /><searchLink fieldCode="DE" term="%22Length+of+stay+in+hospitals%22">Length of stay in hospitals</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+deterioration%22">Clinical deterioration</searchLink><br /><searchLink fieldCode="DE" term="%22Logistic+regression+analysis%22">Logistic regression analysis</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Introduction: Small subcortical infarcts (SSI) are one of the hallmarks of cerebral small vessel disease and have been classified in two different imaging patterns: proximal-SSI (p-SSI) and distal-SSI (d-SSI), according to the shape, size and location to the parent artery. We aimed to investigate imaging and prognosis differences between p-SSI and d-SSI. Methods: We retrospectively reviewed records of consecutive patients with SSI admitted at two Stroke Units. We assessed location, shape and axial diameter of p-SSI and d-SSI with computed tomography (CT) and/or magnetic resonance (MR) imaging blinded to clinical data. Outcomes were: Early Neurological Deterioration (END), length of hospital stay, rehabilitation after discharge and functional status at 3 months assessed with modified Rankin Scale (mRS). We assessed independent associations between type of subcortical stroke and outcomes with logistic and ordinal regression analysis. Results: We included 292 patients, mean (+ -SD) age 67.42 (+ -12.41) years, 205 (70%) males, median (IQR) NIHSS = 4 (2–5); END occurred in 57 (20%) patients. Compared with d-SSI, p-SSI was associated with non-rounded shape (82%vs 65%,p = 0.005), lesion diameter > 15 mm (34% vs 10%,p < 0.001), infratentorial location (39% vs 23%,p = 0.005), absence of white matter changes (22% vs 12%,p = 0.035). END occurred more frequently in p-SSI (44% vs 10%,p < 0.001; OR = 7.23;95%CI = 3.73–14.03). In p-SSI, length of hospital stay was more frequently longer than six days (58% vs 40%,p = 0.005; OR = 1.78;95%CI = 1.04–3.07) and a shift towards worse mRS (cOR = 2.47;95%CI = 1.46–4.18) was observed. Conclusions: d-SSI and p-SSI have different imaging and prognostic characteristics that may suggest a distinct etiological origin and possibly different therapeutic approach. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Neurological Sciences is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s10072-025-08177-9 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 9 StartPage: 3709 Subjects: – SubjectFull: Cerebral small vessel diseases Type: general – SubjectFull: Medical sciences Type: general – SubjectFull: Length of stay in hospitals Type: general – SubjectFull: Clinical deterioration Type: general – SubjectFull: Logistic regression analysis Type: general Titles: – TitleFull: Imaging patterns and prognosis of proximal and distal small subcortical infarcts. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Mombelli, Stefano – PersonEntity: Name: NameFull: Rinaldi, Chiara – PersonEntity: Name: NameFull: Palumbo, Vanessa – PersonEntity: Name: NameFull: Poggesi, Anna – PersonEntity: Name: NameFull: Nencini, Patrizia – PersonEntity: Name: NameFull: Vandelli, Gabriele – PersonEntity: Name: NameFull: Busto, Giorgio – PersonEntity: Name: NameFull: Pascarella, Rosario – PersonEntity: Name: NameFull: Fainardi, Enrico – PersonEntity: Name: NameFull: Zedde, Maria Luisa – PersonEntity: Name: NameFull: Arba, Francesco IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 08 Text: Aug2025 Type: published Y: 2025 Identifiers: – Type: issn-print Value: 15901874 Numbering: – Type: volume Value: 46 – Type: issue Value: 8 Titles: – TitleFull: Neurological Sciences Type: main |
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