Etiologic subtypes of acute multiple infarcts in more than one vascular territories [Birden fazla arter alanının etkilendiği akut çoklu iskemik infarktların etiyolojik subtipleri]

Introduction: etiologic subtype of stroke is usually correlated with the pattern of the lesions on diffusion-weighted imaging (dwi). acute multiple infarcts in more than one cerebrovascular territory (amimct) are consistent with an embolic source proximal to the relevant arteries. the aim of this study was to determine the etiologic subtypes of amimct detected on dwi. methods: we reviewed the charts of the patients who were admitted with acute ischemic stroke. amimct was defined as multiple acute infarcts either in bilateral anterior circulations,or in anterior and posterior circulations simultaneously. the demographic data and etiologic subtypes were recorded. results: there were 83 (14.5%) patients with amimct (48 males [57.8%]; mean age,70.5±13.7 years) and 490 (85.5%) patients with non-amimct (249 males; mean age,69.4±13.2 years). the mean admission nihss score was 6.8± 6.1 in amimct and 5.9±4.6 in non-amimct group (p=0.003). forty (48.2%) patients had a cardioaortic embolic origin. other etiologic subtypes of stroke were large-artery atherosclerosis (n=11,13.3%%),other causes (n=12,14.5%) and undetermined causes (n=20,24.1%). other causes were more prevelant in amimct group (p=0.002). the median mrs was 3 in both groups during the follow-up period. conclusion: cardioaortic embolism is the major cause of amimct,however there are also other mechanisms which could be defined with a detailed work-up. other causes such as severe carotid occlusive disease,hypercoagulability and vasculitis should be investigated in patients with amimct of undetermined etiology. © 2016,ege university press. all right reserved.