Vojtech Novotny‘s PhD thesis clarifies pathophysiological mechanisms and assesses short-term outcome and complications in acute cerebral infarcts in multiple arterial territories.
- Acute cerebral infarcts in more than one arterial territory are associated with cardiogenic embolism.
- Multiple cerebral infarcts after cardioembolism are likely caused by showers of concurrent emboli.
- Patients with acute cerebral infarcts in multiple arterial territories are at increased risk of short-term complications.
Thesis: Acute cerebral infarcts in multiple arterial territories
Candidate: Vojtech Novotny
Time: September 18, 2020 at 12:15
Place: Online-based solution, due to the covid-19 situation
Link to university website (in Norwegian)
Novotny’s papers are based on data from up to 3343 patients included in the Bergen NORSTROKE registry between 2006 and 2013. 9% of the patients had infarcts in multiple cerebral arteries.
(1) Cardioembolism is the most frequent cause of multiple acute cerebral infarcts, which is also independently associated with symptomatic internal carotid artery stenosis. Lesions in at least two different arterial territories are more common in older patients and females.
(2) Time from stroke onset to magnetic resonance imaging is longer in patients who have multiple acute cerebral infarcts caused by internal carotid stenosis. This indicates that these multiple infarcts occur successively separated by hours or days.
However, there is no association between time to MRI and multiple acute cerebral infarcts caused by cardiogenic embolism. This indicates that these multiple infarcts happen concurrently as a shower of emboli.
(3) In-hospital complications such as deep vein thrombosis and myocardial infarction are more frequent in patients with acute cerebral infarcts in multiple arterial territories, compared with patients with infarcts in a single arterial territory.
(4) Nearly three of four patients diagnosed with cerebral infarcts in multiple arteries presented with clinical manifestation in a single arterial territory. These patients generally had less than five ischemic lesions detected on diffusion-weighted MRI.
(1) Novotny, V., Thomassen, L., Waje‐Andreassen, U., & Naess, H. (2017). Acute cerebral infarcts in multiple arterial territories associated with cardioembolism. Acta Neurologica Scandinavica, 135(3), 346-351.
(2) Novotny, V., Khanevski, A. N., Thomassen, L., Waje-Andreassen, U., & Naess, H. (2017). Time patterns in multiple acute cerebral infarcts. International Journal of Stroke, 12(9), 969-975.
(3) Novotny, V., Khanevski, A. N., Bjerkreim, A. T., Kvistad, C. E., Fromm, A., Waje-Andreassen, U., Næss, H., Thomassen, L., & Logallo, N. (2019). Short-Term Outcome and In-Hospital Complications After Acute Cerebral Infarcts in Multiple Arterial Territories. Stroke, 50(12), 3625-3627.
(4) Novotny, V., Aarli, S., Khanevski, A. N., Bjerkreim, A. T., Kvistad, C. E., Fromm, A., Waje-Andreassen, U., Næss, H., Thomassen, L., & Logallo, N. Clinical manifestation of acute cerebral infarcts in multiple arterial Territories. (Currently unpublished)