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From the Research Institute (Dr. Minematsu) and the Cerebrovascular Division, Department of Medicine (Drs. Yamaguchi and Omae), National Cardiovascular Center, Osaka, Japan.
We studied the clinical features of a major hemispheric stroke syndrome with rapid recovery ("spectacular shrinking deficit" [SSD]) compared with stroke patients with the same major initial manifestations but without rapid recovery (non-SSD). There were 118 patients with an initial major hemispheric syndrome; 14 patients (12%) had SSD. All but one SSD patient met criteria for cardiogenic brain embolism. Angiographic examination within 24 hours after stroke onset demonstrated that the occlusion sites in SSD differed from those in non-SSD and suggested that rapid embolus migration had occurred in all SSD patients but in only five of 39 non-SSD. Infarcts in SSD were smaller and often scattered over the cortices and deeper structures. Hemorrhagic transformation was less frequent in SSD. In patients with a potential cardiac source of emboli, SSD was more likely to occur in nondiabetic men less than 60 years of age.
Address correspondence and reprint requests to Dr. Kazuo Minematsu, Neurology, The Medical Center of Central Massachusetts-Memorial, 119 Belmont Street, Worcester, MA 01605.
Supported in part by grants from the Ministry of Health and Welfare, Japan (62-A-2 and 2-A-2) and from the Takeda Medical Research Foundation.
Presented in part at the 43rd annual meeting of the American Academy of Neurology, Boston, MA, April 1991.
Received October 22, 1990. Accepted for publication in final form June 25, 1991.
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