Risk factors and stroke mechanisms in patients with symptomatic cerebral artery atherosclerosis: comparison of young and middle-aged patients

• DOI: 10.3760/cma.j.issn.1673-4165.2016.09.007
• Publication Date: 2016-09-28
• Authors: Hongbing Chen; Zhuhao Li; Jian Zhang; Shaofu He; Gang Liu; Aiwu Zhang; Shujin Tang; Jinsheng Zeng
• Keywords: Stroke; Middle age

Objective To investigate the differences of risk factors and stroke menchanisms between young middle-aged patients with symptomatic cerebral artery atherosclerosis (sCAA).

Methods The (18-44 years) (45-55 sCAA caused ischemic or transient attack admitted to hospital were enrolled consecutively. According distribution patterns acute infarcts on diffusion-weighted imaging, mechanisms identified, including artery-artery embolism (AAE), local branch occlusion (LBO), hemodynamic impairment (HI). Single mechanism was defined as only having 1 mechanism, multiple ≥2 mechanisms.

Results A total 186 enrolled, 138 males. There 82 in youth group (mean 40.11±4.94 years); there 104 51.27±2.97 years). The proportion male significantly higher than that middle-age (81.71% vs. 68.27%; P=0.043), hypertension (70.19% 47.56%; P=0.002) diabetes (38.46% 20.73%; P=0.011) those group. involved middle more common (64.63% 48.08%; P=0.002), basilar (12.50% 3.66%; P=0.037). single both groups (the group, 49/30; 57/42; P=0.645). In mechanisms, AAE+ LBO+ HI (16.46% 6.06%; P=0.030), (21.21% 3.80%; P=0.001).

Conclusions There are significant CAA stroke, suggesting had its unique pathophysiological mechanism. Its control strategy may be different from patients.

Key words: Stroke; Brain Ischemia; Intracranial Arteriosclerosis; Intracranial Embolism; Magnetic Resonance Imaging; Cerebral Angiography; Risk Factors; Young Adult; Middle Aged