Internationale Zeitschrift für Physikalische Medizin und Rehabilitation
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Atherosclerotic Vertebral Artery Occlusive Disease Predicts Poor Functional Outcome in Medullary Infarction

Yasumasa Yamamoto, Naoki Makita, Yoshinari Nagakane

Stroke mechanism of Medullary Infarction (MI) mainly consists of penetrating artery disease (PAD), Large Artery atherosclerotic Occlusive Disease (LAOD) and dissection. The prevalence of stroke mechanism and its correlation with long-term outcome was previously reported. The prevalence of stroke mechanism and its correlation with longterm outcome has been studied. One hundred seven patients with acute isolated medullary infarction including 71 patients with LMI and 36 with MMI from the registration of 3820 consecutive acute ischemic stroke patients were selected. PAD was the most predominant cause and tended to show favorable functional outcome than other two mechanisms. Patients with LAOD showed poor functional outcome one year after onset in both groups of LMI and MMI. Although dissection in LMI exhibited worse functional state in acute phase, it did not show long-term poor outcome. Spontaneous early improvement of luminal narrowing in dissection may contribute to this finding. Atherosclerotic vertebral artery occlusive disease may expose ischemic insults to persistent hemodynamic compromise status. In patients with LAOD, the aggressive medical management or strict control of vascular risk factors should be considered.