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We determined the angiographic presence of extracerebral and intracerebral arterial disease in 122 patients with minor stroke within the carotid territory;we excluded patients with a recognized cardiac source of emboli. Based on clinical features and computed tomographic findings,patients were classified as having lacunar infarcts(n-61),nonlacunar infarcts(n=53),and infarcts of indeterminate type(n=8).Severe carotid bifurcation disease(> minus 50%stenosis or occlusion)was significantly more common in nonlacunar than in lacunar infarcts,on both the ipsilateral(p<0.001)and the contralateral(p<0.01)sides;79%of the patients with nonlacunar infarcts had severe carotid bifurcation and/or middle cerebral artery disease on the ipsilateral side compared with 3.3%of the patients with lacunar infarcts. Our data underscore the need for classification of patients by the underlying mechanisms in future studies of treatment of ischemic stroke. |
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