differential risk factors for lacunar stroke depending on the mri (white and red) subtypes of microangiopathy微分腔隙中风的危险因素取决于微血管病的mri(白色和红色)亚型.pdfVIP

Differential Risk Factors for Lacunar Stroke Depending on the MRI (White and Red) Subtypes of Microangiopathy Jae-Hyun Park, Sookyung Ryoo, Suk Jae Kim, Gyeong-Moon Kim, Chin-Sang Chung, Kwang Ho Lee, Oh Young Bang* Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Abstract Background: Leukoaraiosis and cerebral microbleeds (CMB), which represent cerebral microangiopathy, commonly coexist in patients with acute lacunar stroke. Since they may have different impacts on stroke prognosis and treatment, it is important to know the factors associated with leukoaraiosis-predominant vs. CMB-predominant microangiopathies. Methods: We prospectively recruited 226 patients with acute lacunar infarction and divided them into four groups according to the Fazekas’ score and the presence of CMB: mild, red (predominant CMB), white (predominant leukoaraiosis) and severe microangiopathy groups. For comparison, we also evaluated 50 patients with intracerebral hemorrhage (ICH). We evaluated the clinical and laboratory findings of microangiopathy subtypes in patients with acute lacunar stroke and then compared them with those of primary ICH. Results: The risk factor profile was different among the groups. Patients with acute lacunar infarct but mild microangiopathy were younger, predominantly male, less hypertensive, and more frequently had smoking and heavy alcohol habits than other groups. The risk factor profile of red microangiopathy was similar to that of ICH but differed from that of white microangiopathy. The subjects in the white microangiopathy group were older and more frequently had diabetes than those in the red microangiopathy or ICH group. After adjustments for other factors, age [odds ratio (OR) 1.13; 95% conf