Risk Factors and Stroke Mechanisms in Atherosclerotic Stroke Intracranial Compared With Extracranial and Anterior Compared With Posterior Circulation Disease

Title
Risk Factors and Stroke Mechanisms in Atherosclerotic Stroke Intracranial Compared With Extracranial and Anterior Compared With Posterior Circulation Disease
Author(s)
이준Jong S. Kim[Jong S. Kim]Hyun-Wook Nah[Hyun-Wook Nah]Se Mi Park[Se Mi Park]Su-Kyung Kim[Su-Kyung Kim]Ki Hyun Cho[Ki Hyun Cho]Yong-Seok Lee[Yong-Seok Lee]Jei Kim[Jei Kim]Sang-Won Hah[Sang-Won Hah]Eung-Gyu Kim[Eung-Gyu Kim]
Keywords
ISCHEMIC-STROKE; CEREBRAL ATHEROSCLEROSIS; METABOLIC SYNDROME; POPULATION; LOCATION; REGISTRY; RACE; SEX
Issue Date
201212
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
STROKE, v.43, no.12, pp.3313 - 3318
Abstract
Background and Purpose-The aim of this study was to investigate differences in risk factors and stroke mechanisms between intracranial atherosclerosis (ICAS) and extracranial atherosclerosis (ECAS) and between anterior and posterior circulation atherosclerosis. Methods-A multicenter, prospective, Web-based registry was performed on atherosclerotic strokes using diffusion-weighted magnetic resonance imaging and magnetic resonance angiography. Stroke mechanisms were categorized as artery-to-artery embolism, in situ thrombo-occlusion, local branch occlusion, or hemodynamic impairment. Results-One-thousand patients were enrolled from 9 university hospitals. Age (odds ratio [OR], 1.033; 95% confidence interval [CI], 1.018-1.049), male gender (OR, 3.399; 95% CI, 2.335-4.949), and hyperlipidemia (OR, 1.502; 95% CI, 1.117-2.018) were factors favoring ECAS (vs ICAS), whereas hypertension (OR, 1.826; 95% CI, 1.274-2.618; P=0.001) and diabetes mellitus (OR, 1.490; 95% CI, 1.105-2.010; P=0.009) were related to posterior (vs anterior) circulation diseases. Metabolic syndrome was a factor related to ICAS (vs ECAS) only in posterior circulation strokes (OR, 2.433; 95% CI, 1.005-5.890; P=0.007). Stroke mechanisms included artery-to-artery embolism (59.7%), local branch occlusion (14.9%), in situ -thrombo-occlusion (13.7%), hemodynamic impairment (0.9%), and mixed (10.8%). Anterior ICAS was more often associated with artery-to-artery embolism (51.8% vs 34.0%) and less often associated with local branch occlusion (12.3% vs 40.4%) than posterior ICAS (P<0.001). Conclusions-The prevalence of risk factors and stroke mechanisms differ between ICAS and ECAS, and between anterior and posterior circulation atherosclerosis. Posterior ICAS seems to be closely associated with metabolic derangement and local branch occlusion. Prevention and management strategies may have to consider these differences. (Stroke. 2012; 43: 3313-3318.)
URI
http://hdl.handle.net/YU.REPOSITORY/26794http://dx.doi.org/10.1161/STROKEAHA.112.658500
ISSN
0039-2499
Appears in Collections:
의과대학 > 신경과학교실 > Articles
Files in This Item:
There are no files associated with this item.
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE