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An Investigation between Abnormality of the Blood Vessel and Hemodynamics in Posterior Circulation Ischemia

Author: HanXiaoYun
Tutor: ChengQingZuo
School: Suzhou University
Course: Neurology
Keywords: Posterior circulation ischemia Vascular stenosis Vascular abnormalities Hemoglobin A1c High- density lipoprotein cholesterol Hemodynamic Dysplasia Risk stratification
CLC: R743.3
Type: Master's thesis
Year: 2010
Downloads: 132
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Abstract

Investigate the purpose of the analysis of the first part of the vascular abnormalities with posterior circulation ischemia explore the relationship between vascular abnormalities occur in ischemic situations and after vascular stenosis and related factors change in the posterior circulation. Methods 120 patients with clinically diagnosed patients with posterior circulation ischemia as the control group for the study, 68 cases of earlier health outpatient physical examination. Record of clinical symptoms, signs, neurological examination and stroke risk factors; judgment cranial MRI DWI imaging study, 64 row head CTA observed vascular stenosis variant distribution; relevant factors using multiple linear regression of vascular stenosis analysis; vascular condition and infarction, TIA group were analyzed. Results 1. Cranial MRI and DWI imaging showed that 120 cases of posterior circulation ischemia in patients diagnosed 83 cases of cerebral infarction, transient ischemic attack patients (TIA) 37; 2 the CTA check found 120 cases of posterior circulation ischemia 85 cases of patients with vascular stenosis patients vascular abnormalities in 85 cases, accounting for 70.83%; 23 cases of abnormal blood vessels in the healthy control group of 68 cases, accounting for 33.82% of the two groups there is a significant difference (χ 2 = 24.32, P <0.01); 56 cases, accounting for 65.88%, which left vertebral artery in 17 cases, 20%; dysplasia 22 cases, accounting for 25.88%, of osteophytes oppression or aneurysm, vertebral artery dissection in 7 cases, accounting for 8.24%; circulation in 35 cases after Vascular normal patients, 20 patients with vascular abnormalities of the anterior circulation. After vascular stenosis and high-density lipoprotein cholesterol (HDL-C) was a negative correlation (R2 = 0.266, P <0.05), glycosylated hemoglobin A1c (GHbA1c) was positively correlated (R2 = 0.187, P <0.01), but no significant correlation with age, smoking, gender, body mass index, high blood pressure, low-density lipoprotein cholesterol (LDL-C), homocysteine, fibrinogen levels. The between 5. Vascular abnormalities of cerebral infarction and TIA group distribution without statistically significant difference (χ2 = 0.638, P gt; 0.05). The loop TIA patients conclusion vascular stenosis, abnormal development of the posterior circulation ischemia; anterior circulation vascular abnormalities involved in and contributed to the occurrence of posterior circulation ischemia; closely related to HDL-C, GHbA1c after vascular stenosis; obvious vascular abnormalities should be given high priority. Posterior circulation ischemia hemodynamic changes and related risk factors discussed the purpose of the analysis on the second part of the posterior circulation ischemia hemodynamic changes and related risk factors. Methods 120 patients with clinically diagnosed patients with posterior circulation ischemia as the control group for the study, 68 cases of earlier health outpatient physical examination. Collect medical history data, applications transcranial Doppler ultrasound of the vertebral artery, basilar artery and intracranial large artery exploration, hemodynamic parameters to head CTA vertebral artery and vascular observed. Comparative analysis of the posterior circulation ischemia group and normal control group hemodynamic parameters; the normal developmental abnormalities by comparing 22 cases of vertebral artery side with ABCD2 scoring risk factors to quantify hierarchical contrast different hierarchical hemodynamic changes; dysplasia side hemodynamic changes; 43 patients with anterior circulation artery stenosis in 77 patients with of no anterior circulation stenosis hemodynamic parameters were analyzed. Results hemodynamic parameters of the posterior circulation ischemia group and the control group was significantly different (P <0.05); risk factors to quantify stratification found ABCD2 score 6-7 timesharing vertebral artery and the basilar artery blood flow Kinetic parameters than other layered with a significant difference (P <0.01); skull CTA found 22 cases of vertebral artery dysplasia, developmental adverse side vertebral artery systolic peak velocity (Vs) (P <0.01) lower compared with the contralateral resistance index (RI) increased (P <0.05); 4. associated with anterior circulation artery stenosis group than peak systolic velocity of the anterior circulation stenosis group was significantly lower (P <0.05), resistance index between the two groups showed no statistically significant differences ( P> 0.05). The conclusions of the vertebrobasilar arterial hemodynamics is an important means to assess the posterior circulation ischemia occurred; risk factors for posterior circulation ischemia Quantitative Assessment higher the score, the more obvious the hemodynamic changes; vertebral artery dysplasia, anterior circulation stenosis can cause After hemodynamic abnormalities cause posterior circulation ischemic events.

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