Clinical Analyses of 148 Cases of Cerebral Infarction in Young Adults
|Keywords||cerebral infarction etiology risk factor youth|
Objective: To explore the clinical features of cerebral infarction in young adults, to investigate the etiologies and risk factors, imaging datas, vascular conditions, understand the prognosis and cause of death of the youth cerebral infarction. It is not only help to improve etiological diagnosis for young cerebral infarction but also provide primary prevention for young high-risk groups and the basis for stroke recurrence. As we know there were no large-scale clinical studies about cerebral infarctions in south Jiangsu.Subjects and methods: We retrospectives evaluated 148 young cerebral infarction patients admitted to The Second Affiliated Hospital of Soochow University from January 2006 to December 2010,all patients were confirmed by CT and (or)MRA.In accordance with the age divided all patient into two groups,15~35years group and 35~45years group. The medical history, personal history and the family history cerebrovascular diseases, datas of laboratory and imaging were collected. All patients were classified into different ischemic stroke subtypes according to the OSCP and TOAST criteria. Statistical analysis was performed by using SPSS 17.0 for windows. T test,the mono-factor chi-squared test and multi-factor logistic regression analyses were used to study the etiology, risk factors, clinical feature, imaging, vascular conditions, and prognosis of all patients,Results: There were 104 males and 44 females,average ages is 38.3years old(SD6.7).cerebral infarction of unknown origin is the most common subtypes(31.9%, 47/148), different age groups have different constitutes of etiology, the large artery atherosclerotic cerebral infarction is most common in 35~45 years group(χ2=4.364,P=0.037),The stroke of other demonstrated etiology should be high attention .The highest exposure ratios of risk factors were blood lipid abnormality(56.8%,84/148),different age groups have different risk factors distribution, hypertension(χ2=20.102,P<0.01),blood lipid abnormality(χ2=5.408,P=0.019)is most common in 35~45 years group. Low high-density lipoprotein hyperlipidemia(43.2%) and the homocysteine (66.6%) are the most abnormal indicators in all of the laboratory datas. Univariate analysis of the risk factors between the stroke subtypes showed that hypertension(86.5%,χ2=33.659,P<0.01)increased significantly in the subtypes of small artery cerebral infarction , blood lipid abnormality(81.5%,χ2=10.566,P=0.032),smoking(55.3%,χ2=13.677,P=0.008), family history of cerebrovascular diseases(39.5%,χ2=11.315,P=0.023)increased significantly in the subtypes of large artery atherosclerotic cerebral infarction,lacunar infarcts(47.3%) is most common subtypes according to OSCP criteria, Multiple cerebral infarction is more common in young adult group(P=0.023).Intracranial stenosis is more common than extracranial stenosis in both the carotid and vertebrobasilar systems(χ2=6.279,P=0.012 ) .High low-density lipoprotein hyperlipidemia, low high-density lipoprotein hyperlipidemia, smoking, family history of cerebrovascular diseases closely related to the formation of cerebral artery stenosis.cerebral infarction in young adults have good prognosis ,different age groups had no significant differences in short-term prognosis,but long-term prognosis 15~35 years group is good for 35~45 years group.Conclusion: Most cerebral infarction in young adults is male patients, the incidence of cerebral infarction increased with the age. The cerebral infarction of unknown origin is the most common subtypes; the large artery atherosclerotic cerebral infarction is most common in 35~45 years group. The highest exposure ratios of risk factors were blood lipid abnormality; Hypertension and blood lipid abnormality is most common in 35~45 years group. Hypertension increased significantly in the subtypes of small artery cerebral infarction.Lacunar infarcts are the most common subtypes according to OSCP criteria. Basal ganglion is the most common infarct parts. Multiple cerebral infarctions are more common in 35~45 years group. Intracranial stenosis is more common than extracranial stenosis in both the carotid and vertebrobasilar systems.15~35 years group have more better prognosis.