Distribution of ischemic infarction and stenosis of intra- and extracranial arteries in young Chinese patients with ischemic stroke

Abstract

BackgroundThe distribution of cerebral ischemic infarction and stenosis in ischemic stroke may vary with age-group, race and gender. This study was conducted to understand the risk factors and characteristics of cerebral infarction and stenosis of vessels in young Chinese patients with ischemic stroke.MethodsThis was a retrospective study, from January 2007 to July 2012, of 123 patients ≤50 years diagnosed with acute ischemic stroke. Patient characteristics were compared according to sex (98 males and 25 females) and age group (51 patients were ≤45 years and 72 patients were 46–50 years). Characteristics of acute ischemic infarction were studied by diffusion weighted imaging. Stenosis of intra- and extracranial arteries was diagnosed by duplex sonography, head magnetic resonance angiography (MRA) or cervical MRA.ResultsCommon risk factors were hypertension (72.4 %), dyslipidemia (55.3 %), smoking (54.4 %) and diabetes (33.3 %). Lacunar Infarction was most common in our patients (41.5 %). Partial anterior circulation infarction was predominant in females (52.0 vs 32.7 %; P = 0.073) and posterior circulation infarction in males (19.8 vs 4 %; P = 0.073). Multiple brain infarctions were found in 38 patients (30.9 %). Small artery atherosclerosis was found in 54 patients (43.9 %), with higher prevalence in patients of the 46–50 years age-group. Intracranial stenosis was more common than extracranial stenosis, and middle cerebral artery stenosis was most prevalent (27.3 %). Stenosis in the anterior circulation was more frequent than in the posterior circulation (P < 0.001).ConclusionsIn these young patients, hypertension, smoking, dyslipidemia and diabetes were common risk factors. Intracranial stenosis was most common. The middle cerebral artery was highly vulnerable.

Prevalence and outcome of young stroke patients with middle cerebral artery stenosis

“…In a German nationwide case-control study involving 2125 young stroke patients, eight cardiovascular risk factors combined could explain 78.9% of all strokes [16]. In our study, we found that 83.5% patients has two or more traditional vascular risk factors and the most frequent traditional vascular risk factors include hypertension, hyperlipemia, smoking and alcohol consumption, which is consistent with previous studies [4,17]. We also found that hyperhomocysteinemia, an independent risk factor of stroke, is prevalent in young stroke patients, which has rarely been reported.…”

“…However, these data was mainly collected from European populations. In a study involving 123 Chinese young adults, LAA and small vessel disease (SVD) were the most common causes of acute ischemic stroke [4]. Other studies also showed that proportion of LAA was higher in Asians than that in western populations, indicating that cerebral artery stenosis may be an important cause of stroke in Asian populations [5][6][7].…”

Clinical Characteristics and Prognosis of Patients with COVID-19 Combineded with or without Diabetes, Hypertension or Coronary

“…All patients were up to 18 years old and received throat swab samples which were gathered for SARS-CoV-2 RNA detection by gene sequencing or real-time RT-PCR and the results were positive at least once. Diabetes mellitus was defined as a medical history of diabetes or the use of oral hypoglycemic medication or insulin or patients with a fasting glucose ≥7.0 mmol/L or a two-hour postprandial serum glucose ≥11.1 mmol/L [7]. Hypertension was defined as a medical history of hypertension or the use of antihypertensive, a systolic blood pressure of ≥140 mmHg and/or a diastolic blood pressure of ≥90 mmHg [8].…”

Intracranial artery stenosis: Current status of evaluation and treatment in China

“…Moreover, ICAS was most common in young Chinese patients with ischemic stroke, likely due to high exposure to hypertension, smoking, dyslipidemia, and diabetes. 23 , 24 Thus, more attention and further studies are required for these special subgroups.…”

“…Many studies indicate that vascular risk factors, including hypertension, diabetes mellitus, hyperlipidemia, family history of stroke and heart disorders, smoking, heavy drinking, hyperhomocysteinemia, and overweight, are associated with ICAS. 2 , 16 , 17 , 20 , 21 , 22 , 23 , 24 , 25 However, there are some inconsistencies in the data. Unlike the CICAS study, most studies are limited by, for example, small sample sizes and single-center, retrospective designs.…”