Dissertation
Dissertation > Medicine, health > Neurology and psychiatry > Neurology > Cerebrovascular disease > Acute cerebrovascular disease ( stroke)

The Clinical Study about the Related Factors and Cognitive Function of the Ischemia Cerebrovascular Patients with Cerebral Microbleeds

Author DiFei
Tutor XueRong
School Tianjin Medical University
Course Neurology
Keywords Cerebral microbleeds Cognitive function Related factors Ischemiccerebrovascular
CLC R743.3
Type Master's thesis
Year 2013
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Objective:To investigate the related risk factors and cognitive function of the ischemia cerebrovascular patients with cerebral microbleeds by using Gradient-echo T2-weighted imaging and registrating the risk factors,cognitive function assessment.Methods:Collected122patients who had ischemic cerebrovascular disease in the ward or the clinic in Tianjin general hospital from August2012till March2013. All the patient had been studied with MRI including GRE series,the severity of PVH and DWMH was assessed according to the grading scales reported by Fazekas et al.All the patients had been completed some related chemical and clinical data. They were divided into two groups according to the existence of cerebral microbleeds or not, compared and analyzed the related risk factors of the patients with cerebral microbleeds and the related factors of cerebral microbleeds in different position.84of the patients who had subcortical ischemic cerebrovascular disease were valuated the cognitive function by MMSE,MoCA,to compare and analyze the differences of the total scores of cognitive function and scores of different cognitive domains in patients with or without cerebral microbleeds and the different cognitive domains in patients with cerebral microbleeds in different position.Results:The analysis about the risk factors of cerebral microbleeds in patients with ischemic cerebrovascular disease:1. Evidence of CMBs was found in25.40%of all subjects,the number of CMBs lesions in deep CMBs was144,which was94in cortico-subcortical CMBs2. Univariate analysis showed that the presence of CMBs were associated with age, hypertension,presence of lacunar infarcts, white matter hyperintensity,recurrent stroke (P<0.05),the proportion of antiplatelet use in patient with CMBs was higher than that without CMBs,but no statistically difference(P<0.05).3. Multiple logistic regression analysis showed that independent and significant factors associated with the presence of CMBs were age, hypertension,presence of lacunar infarcts. Hypertension were associated with deep CMBs and age were associ-ated with cortico-subcortical CMBs independently.4. The number of lacunar infarcts and grades of PVH and DWMH were associated with the grades of CMBs(r=0.383, P<0.001; r=0.327,P<0.001; r=0.351,P<0.001).5.No statistically significant difference in the incidence of carotid stenosis and plaque in patient with or without CMBs (P>0.05).The correlation between cerebral microbleeds and cognitive dysfunction in patients with cortico-subcortical ischemic cerebrovascular disease:1. Compared with patients who had no CMBs,score of MMSE, MOCA, attention, visuospatial skill/excusive, delays recall was lower in patients with CMBs.(P<0.05)2. Cortico-subcortical CMBs were associated with lower score of MMSE,MOCA, attention, visuospatial skill/excusive,delays recall,language.(P<0.05)3. Deep CMBs were associated with lower score of MMSE, MOCA,attention, visuospatial skill/excusive.(P<0.05)Conclusion:1. Age, hypertension,presence of lacunar infarct were significantly independent predictors for cerebral microbleeds. Age is associated with cortico-subcortical CMBs independently.Hypertension is associated with deep CMBs independently.2. The number of lacunar infarct and severity of PVH and DWMH was associated with the severity of CMBs. Speculate that they might share same angiopathy change in pathology.They are the different imaging performance of small vessel disease.3. CMBs was not associated with carotid atherosclerosis in patients who have ischemic cerebrovascular disease.4. CMBs was associated with worse of global cognitive function,visuospatial skill/excusive,attention,language,delays recall in patient who have subcortical ischemic cerebrovascular disease. Speculated that CMBs is associated with cognitive impairment.5. Cortical-subcortical CMBs and deep CMBs were not only associated with the worse of global cognitive function,but aslo be associated with impairment of different cognitive domains.

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