ArticleCerebrovascular diseases (Basel, Switzerland)2010
Associations of clinical stroke misclassification ('clinical-imaging dissociation') in acute ischemic stroke.
Article in Cerebrovascular diseases (Basel, Switzerland), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 4 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 4 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Implications of Cranial Arterial Stenosis and Dolichoectasia for Cerebral Small-Vessel Disease Etiopathogenesis: Findings From a Prospective Mild Stroke Cohort.Circulation · 2026Pooled it
- European stroke organisation (ESO) guideline on cerebral small vessel disease, part 2, lacunar ischaemic stroke.European stroke journal · 2024Guideline
- Cerebral small vessel disease and renal function: systematic review and meta-analysis.Cerebrovascular diseases (Basel, Switzerland) · 2015Pooled it
- Pathology of lacunar ischemic stroke in humans--a systematic review.Brain pathology (Zurich, Switzerland) · 2012Pooled it
- Early renal dysfunction and fibroblast growth factor-23 in patients with small vessel disease-related stroke.Scientific reports · 2019Trial
- Functional Outcome of Intravenous Thrombolysis in Patients With Lacunar Infarcts in the WAKE-UP Trial.JAMA neurology · 2019Trial
- Design of trials in lacunar stroke and cerebral small vessel disease: review and experience with the LACunar Intervention Trial 2 (LACI-2).Stroke and vascular neurology · 2024Review
- Recurrent cerebrovascular events after recent small subcortical infarction.Journal of neurology · 2024Article
- Stroke Subtype Among Individuals With Chronic Kidney Disease.Canadian journal of kidney health and disease · 2023Article
- Long-term mortality and recurrent vascular events in lacunar versus non-lacunar ischaemic stroke: A cohort study.European stroke journal · 2022Article
- The Potential Impact of Neuroimaging and Translational Research on the Clinical Management of Lacunar Stroke.International journal of molecular sciences · 2022Review
- Attack Interval Is the Key to the Likely Pathogenesis of Multiple Transient Ischemic Attacks.Cerebrovascular diseases extra · 2021Article
- Clinical management of cerebral small vessel disease: a call for a holistic approach.Chinese medical journal · 2020Review
- Lacunar stroke syndromes as predictors of lacunar and non-lacunar infarcts on neuroimaging: a hospital-based study.Internal and emergency medicine · 2020Observational
- Symptoms and probabilistic anatomical mapping of lacunar infarcts.Neurological research and practice · 2020Article
- Treatment Approaches to Lacunar Stroke.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2019Review
- Are morphologic features of recent small subcortical infarcts related to specific etiologic aspects?Therapeutic advances in neurological disorders · 2019Article
- Article
- Update on cerebral small vessel disease: a dynamic whole-brain disease.Stroke and vascular neurology · 2016Review
- Longitudinal Assessment of Motor Recovery of Contralateral Hand after Basal Ganglia Infarction Using Functional Magnetic Resonance Imaging.BioMed research international · 2016Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundUp to 20% of lacunar infarcts are clinically misdiagnosed as cortical infarcts and vice versa. The reasons for this discrepancy are unclear. We assessed clinical and imaging features which might explain this 'clinical-imaging dissociation' (C-ID).
methodsPatients with an acute stroke syndrome (cortical or lacunar) underwent magnetic resonance imaging including diffusion-weighted imaging (DWI). We recorded DWI-positive infarcts and proximity to cortex for small subcortical infarcts. We examined factors associated with C-ID.
results137 patients with a mild cortical or lacunar syndrome had an acute ischemic lesion on DWI. Of these, 21/93 (23%) with a cortical syndrome had an acute lacunar infarct and 7/44 (16%) with a lacunar syndrome had an acute cortical infarct. From 72 patients with an acute lacunar infarct on DWI, lesion proximity to cortex (odds ratio (OR) 14.5, 95% confidence interval (CI) 1.61-130.1), left hemisphere location (OR 8.95, 95% CI 1.23-64.99) and diabetes (OR 17.1, 95% CI 1.49-196.16) predicted C-ID. On multivariate analysis of all 137 patients, C-ID was associated with diabetes (OR 7.12, 95% CI 1.86-27.2).
conclusionsC-ID occurs in a fifth of patients with mild stroke. Lacunar infarcts lying close to cortex are more likely to cause cortical symptoms. Diabetes is associated with any clinical-imaging mismatch. Stroke misclassification which can arise with clinical classification alone should be minimized in research by verification with high-sensitivity imaging.
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