Clinical Characteristics and Outcome of Patients with Lacunar Infarcts and Concurrent Embolic Ischemic Lesions

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ORIGINAL ARTICLE

Clinical Characteristics and Outcome of Patients with Lacunar Infarcts and Concurrent Embolic Ischemic Lesions Ewgenia Barow1 · Florent Boutitie2,17,18 · Bastian Cheng1 · Tae-Hee Cho3 · Martin Ebinger4,5 · Matthias Endres4,6 · Jochen B. Fiebach4 · Jens Fiehler7 · Ian Ford8 · Ivana Galinovic4 · Alina Nickel1 · Josep Puig9 · Pascal Roy2,17,18 · Anke Wouters10,11,12 · Vincent Thijs13,14 · Robin Lemmens10,11,12 · Keith W. Muir15 · Norbert Nighoghossian3 · Salvador Pedraza9 · Claus Z. Simonsen16 · Christian Gerloff1 · Götz Thomalla1 · WAKE-UP investigators Received: 11 February 2019 / Accepted: 13 May 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019

Abstract Purpose Lacunar infarcts are thought to result from occlusion of small penetrating arteries due to microatheroma and lipohyalinosis, pathognomonic for cerebral small vessel disease (CSVD). Concurrent embolic ischemic lesions indicate a different stroke mechanism. The purpose of this study was to examine the clinical characteristics and outcome of patients with lacunar infarcts and concurrent embolic infarcts on diffusion-weighted imaging (DWI). Methods All patients screened for the WAKE-UP trial (ClinicalTrials.gov number, NCT01525290) were reviewed for acute lacunar infarcts and concurrent embolic lesions on baseline DWI. Clinical characteristics and outcome were compared between lacunar infarct patients with and without concurrent embolic lesions.

Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00062-019-00800-5) contains supplementary material, which is available to authorized users.

8

Robertson Centre for Biostatistics, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK

9

Department of Radiology, Institut de Diagnostic per la Image (IDI), Hospital Dr Josep Trueta, Institut d’Investigació Biomèdica de Girona (IDIBGI), Parc Hospitalari Martí i Julià de Salt—Edifici M2, 17190 Salt, Girona, Spain

10

Department of Neurology, University Hospitals Leuven, Herestraat 49, 3000 Leuven, Belgium

11

Department of Neurosciences, Experimental Neurology, KU Leuven—University of Leuven, Oude Markt 13, bus 5005, 3000 Leuven, Belgium

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Laboratory of Neurobiology, Campus Gasthuisberg, VIB, Center for Brain & Disease Research, Herestraat 49, bus 602, 3000 Leuven, Belgium

13

Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy Street, VIC 3084 Heidelberg, Victoria, Australia

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Department of Neurology, Austin Health, 145 Studley Road, VIC 3084 Heidelberg, Australia

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Institute of Neuroscience & Psychology, University of Glasgow, University Avenue, Glasgow, G12 8QQ, UK

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Department of Neurology, Aarhus University Hospital, 8000 Aarhus, Denmark

17

Université Lyon 1, 69100 Villeurbanne, France

18

CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, 69100 Villeurbanne, France

 Ewgenia Barow

[email protected] 1

Klinik und Poliklinik für Neurologie, Kopfund Neurozentrum, Univer