Clinical Researches
Risk factors and stroke mechanisms in patients with symptomatic cerebral artery atherosclerosis: comparison of young and middle-aged patients
Hongbing Chen, Zhuhao Li, Jian Zhang, Shaofu He, Gang Liu, Aiwu Zhang, Shujin Tang, Jinsheng Zeng
Published 2016-09-28
Cite as Int J Cerebrovasc Dis, 2016, 24(9): 819-826. DOI: 10.3760/cma.j.issn.1673-4165.2016.09.007
Abstract
ObjectiveTo investigate the differences of risk factors and stroke menchanisms between young and middle-aged patients with symptomatic cerebral artery atherosclerosis (sCAA).
MethodsThe young (18-44 years) and middle-aged (45-55 years) patients with sCAA caused ischemic stroke or transient ischemic attack admitted to hospital were enrolled consecutively. According the distribution patterns of acute infarcts on the diffusion-weighted imaging, the stroke mechanisms of sCAA were identified, including artery-artery embolism (AAE), local branch occlusion (LBO), and hemodynamic impairment (HI). Single stroke mechanism was defined as only having 1 mechanism, and multiple stroke mechanisms were defined as having ≥2 mechanisms.
ResultsA total of 186 patients were enrolled, and 138 patients were males. There were 82 patients in the youth group (mean 40.11±4.94 years); there were 104 patients in the middle-aged group (mean 51.27±2.97 years). The proportion of male in the youth group was significantly higher than that in the middle-age group (81.71% vs. 68.27%; P=0.043), and hypertension (70.19% vs. 47.56%; P=0.002) and diabetes (38.46% vs. 20.73%; P=0.011) in the middle-aged group were significantly higher than those in the youth group. sCAA involved the middle cerebral artery was more common in the youth group (64.63% vs. 48.08%; P=0.002), and sCAA involved the basilar artery was more common in the middle-aged group (12.50% vs. 3.66%; P=0.037). The single or multiple stroke mechanisms were more common in both groups (the youth group, 49/30; the middle-aged group 57/42; P=0.645). In multiple stroke mechanisms, AAE+ LBO+ HI in the youth group was more common (16.46% vs. 6.06%; P=0.030), and AAE+ HI was more common in the middle-aged group (21.21% vs. 3.80%; P=0.001).
ConclusionsThere are significant differences in the risk factors and stroke mechanisms between the young and the middle-aged patients with CAA stroke, suggesting that the young patients with sCAA had its unique pathophysiological mechanism. Its control strategy may be different from the middle-aged patients.
Key words:
Stroke; Brain Ischemia; Intracranial Arteriosclerosis; Intracranial Embolism; Magnetic Resonance Imaging; Cerebral Angiography; Risk Factors; Young Adult; Middle Aged
Contributor Information
Hongbing Chen
Department of Neurology and Stroke Center, the First Affiliated Hospital of SUN Yat-Sen University, Guangzhou 510080, China
Zhuhao Li
Department of Radiology, the First Affiliated Hospital of SUN Yat-Sen University, Guangzhou 510080, China
Jian Zhang
Department of Neurology and Stroke Center, the First Affiliated Hospital of SUN Yat-Sen University, Guangzhou 510080, China
Shaofu He
Department of Radiology, the First Affiliated Hospital of SUN Yat-Sen University, Guangzhou 510080, China
Gang Liu
Department of Neurology and Stroke Center, the First Affiliated Hospital of SUN Yat-Sen University, Guangzhou 510080, China
Aiwu Zhang
Department of Neurology and Stroke Center, the First Affiliated Hospital of SUN Yat-Sen University, Guangzhou 510080, China
Shujin Tang
Department of Neurology and Stroke Center, the First Affiliated Hospital of SUN Yat-Sen University, Guangzhou 510080, China
Jinsheng Zeng
Department of Neurology and Stroke Center, the First Affiliated Hospital of SUN Yat-Sen University, Guangzhou 510080, China
