動脈硬化性病変に起因する脳梗塞の「原因」に関する一考察  [in Japanese] The Consideration on the Source of Cerebral Infarction Derived from Arterial Sclerotic Lesions  [in Japanese]

We recruited 229 consecutive patients (145 men) aged 29-96 years (mean 70 years). All gave informed consent in this study. Patients were classified into "cardiogenic embolism (cardiogenic), " "atherothrombotic stroke (atheroma), " "lacuna stroke (lacuna)" and "others." In "atheroma" and "lacuna" groups, significant arterial stenosis as the source was disclosed in 55.6%. The stenotic lesions considerably existed in the extra-cranial region, such as cervical internal carotid artery, foraminal segment of the vertebral artery, or vertebral artery origin. In half of the patients with previous attacks, significant arterial lesions were identified as the source. The symptoms caused by these arterial lesions tended to be slight. Therefore, the source may be overlooked, resulting in relapse. Determining the source is important as careful neurological assessment may enable a favorable clinical outcome.