지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2013.1
- 수록면
- 97 - 102 (6page)
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Background and Purpose Understanding the mechanisms underlying stroke can aid the development of therapies and improve the final outcome. The purposes of this study were to establish whether there are characteristic mechanistic differences in the frequency, severity, functional outcome, and mortality between left- and right-hemisphere ischemic stroke and, given the velocity differences in the carotid circulation and direct branching of the left common carotid artery from the aorta, whether large-vessel ischemia (including cardioembolism) is more common in the territory of the left middle cerebral artery.
Methods Trial cohorts were combined into a data set of 476 samples. Using Trial of Org 10172 in Acute Stroke Treatment criteria, ischemic strokes in a total 317 patients were included in the analysis. Hemorrhagic stroke, stroke of undetermined etiology, cryptogenic stroke, and bilateral ischemic strokes were excluded. Laterality and vascular distribution were correlated with outcomes using a logistic regression model. The etiologies of the large-vessel strokes were atherosclerosis and cardioembolism.
Results The overall event frequency, mortality, National Institutes of Health Stroke Scale (NIHSS)score, Glasgow Coma Scale score, and rate of mechanical thrombectomy interventions differed significantly between the hemispheres. Left-hemispheric strokes (54%) were more common than right-hemispheric strokes (46%; p=0.0073), and had higher admission NIHSS scores (p=0.011),increased mortality (p=0.0339), and higher endovascular intervention rates (p≤0.0001). ischemic strokes were more frequent in the distribution of the left middle cerebral artery (122 vs. 97;p=0.0003) due to the higher incidence of large-vessel ischemic stroke in this area (p=0.0011).
Conclusions Left-hemispheric ischemic strokes appear to be more frequent and often have a worse outcome than their right-hemispheric counterparts. The incidence of large-vessel ischemic strokes is higher in the left middle cerebral artery distribution, contributing to these hemispheric differences. The hemispheric differences exhibit a nonsignificant trend when strokes in the middle cerebral artery distribution are excluded from the analysis.
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참고문헌 (19)
참고문헌 신청
/ 1997 / Generalized efficacy of t-PA for acute stroke. Subgroup analysis of the NINDS t-PA Stroke Trial / Stroke 28 : 2119 ~ 2125
Adams HP Jr / 1993 / Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatm
Ances BM / 2009 / Effects of aging on cerebral blood flow, oxygen metabolism, and blood oxygenation level dependent responses to visual stimulation / Human Brain Mapping 30
Arditi H / 2007 / Cerebral blood flow velocity asymmetry, neurobehavioral maturation, and the cognitive development of premature infants across the first two years / Journal
Cassvan A / 1976 / Lateralization in stroke syndromes as a factor in ambulation / Archives of Physical Medicine and Rehabilitation 57 : 583 ~ 587
Adams HP Jr / 1993 / Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatm
Ances BM / 2009 / Effects of aging on cerebral blood flow, oxygen metabolism, and blood oxygenation level dependent responses to visual stimulation / Human Brain Mapping 30
Arditi H / 2007 / Cerebral blood flow velocity asymmetry, neurobehavioral maturation, and the cognitive development of premature infants across the first two years / Journal
Cassvan A / 1976 / Lateralization in stroke syndromes as a factor in ambulation / Archives of Physical Medicine and Rehabilitation 57 : 583 ~ 587
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