Stroke topography in diabetic and nondiabetic patients by magnetic resonance imaging

Stroke is more frequent in diabetic than in nondiabetic patients. We studied lesion topography in 61 stroke patients with diabetes mellitus and 77 without diabetes using magnetic resonance imaging. Location, number and size of infarcts were investigated. Prevalence of hypertension did not differ between diabetic and nondiabetic patients. In elderly subgroups (greater than or equal to 65 years), infratentorial infarcts greater than or equal to 5 mm in diameter were more frequent in diabetic than in nondiabetic patients (32 vs. 12%, P < 0.05), while supratentorial infarcts were not different (56 vs. 68%, ns). Asymptomatic hemorrhage combined with silent infarction was significantly less frequent in diabetic than in nondiabetic patients (5 vs. 22%, P < 0.05). In nondiabetic patients with significant stenosis in the carotid system, supratentorial infarction measuring greater than or equal to 15 mm was more frequent than in those without stenotic lesions, but the number of infarcts per patient irrespective of size was smaller when stenosis was present. On the other hand, the number of infarcts in diabetic patients was similar between those with and without carotid system stenosis. The present study demonstrated that infratentorial infarcts were more common in elderly diabetic patients, suggesting the vulnerability of vertebrobasilar circulation in diabetes. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.