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During a 1-year period,we prospectively studied the mechanism and severity of stroke in 47 patients sustaining a cerebral infarction while taking aspirin.The mechanism of stroke was undetermined in 12 patients(26%).In the remaining 35 patients,we identified 39 potential mechanisms:large- artery atherosclerosis(19 patients,40%),cardioembolism(15 patients,32%), and small-vessel occlusive disease(5 patients,11%).Of 11 patients with carotid atherosclerosis and stroke,9(82%)had>90%carotid stenosis or occlusion;of 12 patients with stroke of undetermined mechanism,10(83%)had previous stroke,of which 8 were also of undetermined mechanisms.Disability after stroke was moderate or severe in 27 patients(57%).These data suggest that(1)stroke in patients taking aspirin has a variety of etiologies and frequently causes moderate or severe disability;(2)patients with carotid disease failing aspirin often have high-grade carotid stenosis or occlusion;(3)stroke of undetermined mechanism may recur more frequently than other stroke subtypes in patients taking aspirin. |
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aspirin aspirin,failure of carotid artery disease cerebral embolism,cardiac origin cerebrovascular accident cerebrovascular accident,etiology
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