A classification trial of cerebral infarction.

DOI
  • Yamada Yasuyo
    First Department of Internal Medicine, School of Medicine, Fukuoka University
  • Nishimaru Katsuya
    First Department of Internal Medicine, School of Medicine, Fukuoka University
  • Abe Hirofumi
    First Department of Internal Medicine, School of Medicine, Fukuoka University

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  • 脳梗塞の臨床病型分類の試み

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A total of 160 patients (114 males and 46 females; average age, 63.4 years old) with cerebral infarction were classified according to the cerebrovascular disease classification III proposed by NINDS, U.S.A. Since the NINDS classification does not specify detailed diagnostic criteria, we adapted our own test findings to establish a precise diagnosis. Patients with classic lacunar syndrome, who were found to have lesions of less than 15 mm in diameter or no lesiion, were diagnosed as lacunar infarction. Patients with a cardioembolic source and sudden onset were diagnosed as cardioembolic infarction, while 24 patients (15.0%) with vascular lesion that were determined to be the cause of infarction were diagnosed as atherothrombotic infarction. Furthermore, 55 patients (34.4%) who were diagnosed as having small lesions based on neurological examinations and correlative tomographic findings were added to the group of lacunar infarction, and 32 patients (20.0%) who were found to have a cardioembolic source and were diagnosed as cardiac embolization based on the manner of onset and tomographic findings were added to the group of cardioembolic infarction. At the final count, 49 patients (30.6%) were unable to be classified. The incidence of lacunar infarction in our patients was slightly higher than that reported in the U.S.A., while the incidence of other subtypes was similar to that in the U.S.A. There was a tendency towards a reverse correlation between the incidence of atherothrombotic infarction and that of unclassified infarction, which could probably be explained by the inability to determine the exact nature of the vascular lesions. Further development of clinical test method should decrease the incidence of unclassified cases of infarction.

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