MATCH（Management of Atherothrombosis with Clopidogel in High—Risk Patients with Recent Transient Ischemic or Ischemic Stroke）试验是针对近期发生短暂性脑缺血发作（TIA）或缺血性卒中患者进行的大规模临床研究，为一项国...MATCH（Management of Atherothrombosis with Clopidogel in High—Risk Patients with Recent Transient Ischemic or Ischemic Stroke）试验是针对近期发生短暂性脑缺血发作（TIA）或缺血性卒中患者进行的大规模临床研究，为一项国际性多中心随机双盲对照临床试验。初级目标是评价氯吡格雷与阿司匹林联合应用能否获得更多临床效益以及进一步减少缺血事件（心肌梗死、缺血性卒中、血管性死亡事件及因急性缺血事件再住院）的发生。共有28个国家的507个医疗中心参与了该项研究，共纳入7599例受试者，随访18个月。展开更多
Background and Purpose - Thalamic infarcts have traditionally been classified into 4 territories: anterior, paramedian, inferolateral, and posterior. The purpose of this study was to review this classical versus varia...Background and Purpose - Thalamic infarcts have traditionally been classified into 4 territories: anterior, paramedian, inferolateral, and posterior. The purpose of this study was to review this classical versus variant distribution in patients with thalamic stroke. Methods - We reviewed all patients with a first clinical stroke included in the Lausanne Stroke Registry between 1990 and 2002. Among 71 patients with an acute stroke isolated to the thalamus confirmed by MRI, we selected all patients with lesions outside the classical territories and studied their clinical, etiological, and radiological features. Results - A total of 21 patients (30% of all thalamic stroke patients) showed infarction outside the classical territories, allowing us to delineate 3 variant distributions: (1) Anteromedian territory (9 patients [13% Abstract:) involving anterior and paramedian territories, with predominantly cognitive impairment, including executive dysfunction, anterograde amnesia, and aphasia in left- sided or bilateral lesions. The most frequent stroke mechanism was cardiac embolism. (2) Central territory (4 patients [6% Abstract:), with lesions on the central part of the thalamus, resulting in a variety of neurological and neuropsychological signs, reflecting the involvement of several adjacent structures. Microangiopathy was the most frequent etiology. (3) Posterolateral territory (8 patients [11% Abstract:), involving inferolateral and posterior territories, with hemihypesthesia as the most frequent manifestation, followed by hemiataxia, executive dysfunction, and aphasia in left- sided lesions. Artery- to- artery embolism and microangiopathy were the main stroke mechanisms. Conclusions - We describe 3 variant topographic patterns of thalamic infarction with distinct manifestations and etiologies. We postulate that these infarcts are the result of a variation in thalamic arterial supply or reflect borderzone ischemia.展开更多
文摘MATCH（Management of Atherothrombosis with Clopidogel in High—Risk Patients with Recent Transient Ischemic or Ischemic Stroke）试验是针对近期发生短暂性脑缺血发作（TIA）或缺血性卒中患者进行的大规模临床研究，为一项国际性多中心随机双盲对照临床试验。初级目标是评价氯吡格雷与阿司匹林联合应用能否获得更多临床效益以及进一步减少缺血事件（心肌梗死、缺血性卒中、血管性死亡事件及因急性缺血事件再住院）的发生。共有28个国家的507个医疗中心参与了该项研究，共纳入7599例受试者，随访18个月。
文摘Background and Purpose - Thalamic infarcts have traditionally been classified into 4 territories: anterior, paramedian, inferolateral, and posterior. The purpose of this study was to review this classical versus variant distribution in patients with thalamic stroke. Methods - We reviewed all patients with a first clinical stroke included in the Lausanne Stroke Registry between 1990 and 2002. Among 71 patients with an acute stroke isolated to the thalamus confirmed by MRI, we selected all patients with lesions outside the classical territories and studied their clinical, etiological, and radiological features. Results - A total of 21 patients (30% of all thalamic stroke patients) showed infarction outside the classical territories, allowing us to delineate 3 variant distributions: (1) Anteromedian territory (9 patients [13% Abstract:) involving anterior and paramedian territories, with predominantly cognitive impairment, including executive dysfunction, anterograde amnesia, and aphasia in left- sided or bilateral lesions. The most frequent stroke mechanism was cardiac embolism. (2) Central territory (4 patients [6% Abstract:), with lesions on the central part of the thalamus, resulting in a variety of neurological and neuropsychological signs, reflecting the involvement of several adjacent structures. Microangiopathy was the most frequent etiology. (3) Posterolateral territory (8 patients [11% Abstract:), involving inferolateral and posterior territories, with hemihypesthesia as the most frequent manifestation, followed by hemiataxia, executive dysfunction, and aphasia in left- sided lesions. Artery- to- artery embolism and microangiopathy were the main stroke mechanisms. Conclusions - We describe 3 variant topographic patterns of thalamic infarction with distinct manifestations and etiologies. We postulate that these infarcts are the result of a variation in thalamic arterial supply or reflect borderzone ischemia.
