High glycated hemoglobin levels and intracranial artery stenosis are predictive factors for early motor worsening events in patients with penetrating artery infarction

Eur Neurol. 2012;68(1):16-9. doi: 10.1159/000335890. Epub 2012 Jun 1.

Abstract

Background: The purpose of this study was to identify typical clinical characteristics to predict early motor worsening (EMW) of patients with penetrating artery infarction.

Methods: We reviewed 65 consecutive patients with pure motor hemiparesis, sensorimotor stroke, and ataxic hemiparesis. EMW was defined as deterioration by ≥1 point on the National Institutes of Health Stroke Scale for motor function within 5 days of admission.

Results: EMW was observed in 22 patients (34%). HbA1c levels were higher in patients with EMW than in those without EMW (7.9 ± 2.6 vs. 6.3 ± 1.6%; p < 0.01). The percentage of EMW patients with intracranial artery stenosis (ICAS) was greater than that of non-EMW patients with ICAS (13/22 patients, 59% vs. 8/43 patients, 19%; p < 0.01). Multivariate logistic regression analysis indicated that HbA1c levels ≥7.0% (OR 3.0, 95% CI 1.5-6.8; p < 0.005) or ICAS (OR 2.3, 95% CI 1.2-4.8; p < 0.05) increased the risk of EMW, and the combination of these factors increased the risk in an additive manner (OR 7.6, 95% CI 2.5-40; p < 0.005).

Conclusion: HbA1c levels ≥7.0% and/or ICAS in patients with penetrating artery infarction are associated with EMW.

MeSH terms

  • Aged
  • Brain Infarction / blood
  • Brain Infarction / complications*
  • Brain Infarction / pathology
  • Carotid Stenosis / pathology*
  • Female
  • Glycated Hemoglobin / analysis*
  • Humans
  • Magnetic Resonance Angiography
  • Magnetic Resonance Imaging
  • Male
  • Movement Disorders / blood
  • Movement Disorders / etiology*
  • Movement Disorders / pathology

Substances

  • Glycated Hemoglobin A