| Abstract [eng] |
more (very old patients, VOP) are poorly studied, and it is difficult to define the mechanism of stroke in VOP. Purpose. To evaluate whether risk factors, coexisting causes of stroke, clinical features in VOP with first lacunar infarction differ from those in patients aged 45–79 years (younger patients, YP). Methods. We studied 102 VOP with first lacunar infarction and compared them with 612 YP. Results. VOP with presumed small vessel disease infarction had a lower frequency of male sex, hypercholesterolemia, smoking, and family history of stroke or heart disease than YP, independently of coexisting sources of embolism. While a potential cardiac source of embolism was more frequent in VOP than in YP (29.4% vs. 11.4%, p < 0.001), the frequency of concomitant large vessel disease did not differ between the two groups (7.2% vs. 5.9%, p > 0.05). <50% ICA (internal carotid artery) stenosis was an independent predictor for “pure” small vessel disease infarction in both age groups. The association between diabetes and “pure” small vessel disease, seen in YP, failed in the VOP group. The VOP group with “pure” small vessel disease showed a higher frequency of immediately stabilized neurologic deficit than did the YP group (80.3% vs. 68.4%, p = 0.047). Conclusions. The age-related risk factors show that small vessel disease infarction in VOP more frequently shares the features that are common for large vessel disease than in YP. The clinical picture suggests a higher frequency of small vessel disease in VOP compared to YP with small vessel disease and coexisting cardioembolic source. |
