In patients with acute ischemic stroke, large infarcts were common when cardiac disease was the sole embolic source and uncommon when aortic atheroma was the sole source (p < 0.0001).
Observational (n=270)
DWI and TEE findings can help characterize cardiogenic, paradoxical, and aortogenic brain embolism, as embolic stroke has unique clinical features depending on its source.
Background and Purpose: The purpose of the present study was to clarify the difference in the infarct topography on diffusion-weighted image (DWI) and cardiac and aortic findings on transesophageal echocardiography (TEE) in stroke patients with different embolic sources. Methods: We studied 270 consecutive patients with acute ischemic stroke who had DWI-documented cortical or subcortical infarcts without significant stenosis of the cerebral arteries. As embolic sources, cardiac diseases, right-to-left shunt diseases and an aortic arch atheroma ≧4.0 mm in thickness were identified using various diagnostic tools including TEE. Results: Seventy-eight (29%) patients had multiple embolic sources. Large infarcts were common in patients in whom cardiac disease was the only embolic source and uncommon in patients in whom aortic atheroma was the only embolic source (p Conclusions: Embolic stroke patients often have multiple embolic sources. The present study suggests the possibility that embolic stroke has unique clinical features depending on its source. DWI and TEE findings might be helpful in characterizing cardiogenic, paradoxical and aortogenic brain embolism.
Fujimoto et al. (Sat,) conducted a observational in Acute ischemic stroke (n=270). Embolic sources (cardiac, right-to-left shunt, aortic arch atheroma) vs. Between different embolic sources was evaluated on Difference in infarct topography on DWI and cardiac/aortic findings on TEE. In patients with acute ischemic stroke, large infarcts were common when cardiac disease was the sole embolic source and uncommon when aortic atheroma was the sole source (p < 0.0001).