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Multiple acute cerebral infarcts on diffusion-weighted imaging and risk of recurrent stroke

From the Division of Neurology, Departments of Medicine and Therapeutics (Drs. Wen, Fan, Leung, and Wong), Chinese University of Hong Kong, Hong Kong; Department of Neurology (Dr. Wen), Zhong Shan University First Affiliated Hospital, Guangzhou, China; Departments of Diagnostic Radiology and Organ Imaging (Drs. Lam and Chan) and Accident and Emergency Medicine Academic Unit (Dr. Rainer), Chinese University of Hong Kong, Hong Kong, China.

Address correspondence and reprint requests to Dr. Ka Sing Wong, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong; e-mail: ks-wong{at}cuhk.edu.hk

Multiple acute cerebral infarcts (MACIs) detected by diffusion-weighted imaging (DWI) may indicate an unstable source of thromboembolism. The authors studied 119 consecutive acute ischemic stroke patients within 24 hours of onset with DWI. MACIs were present in 20 patients (16.8%). During the follow-up period, there were 15 recurrent strokes, 3 acute coronary syndromes, and 5 deaths. MACI was the only significant independent predictor for vascular events and death (odd ratio [OR]] = 4.34; p = 0.001) and stroke recurrence (OR = 5.93; p = 0.001).

Received January 8, 2004. Accepted in final form June 1, 2004.

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