The Characteristics Of Cerebral Vascular Stenosis Represented As Brief Loss Of Consciousness

Brief loss of consciousness is one of the common clinical symptoms of neurological department and is the rare representation of cerebral vascular stenosis, and also is the serious representation of transient ischemic attack (TIA). TIA (transient ischemic attack) is an emergency of neurological department, one third untreated cases of which are to develop into cerebral infarction, one third may have repeated attacks, and one third may heal. Cerebral vascular stenosis is the foundation of pathological changes of ischemic stroke, so there are more dangers of stroke in TIA resulted from this which is accompanied with brief loss of consciousness. However, clinically, a patient with brief loss of consciousness is often taken in consideration as epilepsy or syncope first, and the physician doesn't pay enough attention to the cause of cerebral vascular stenosis. So many patients can't release from the causes radically, which result in the repeat of symptoms and further stroke, many of them suffer from hurt both mentally and physically. Abroad, there are few reports about brief loss of consciousness resulting from the stenosis of cerebral vascular, and also, until recent years, some clinical physicians begin to draw attention to this at home. Some literature show that for the patients with cerebral vascular stenosis represented as brief loss of consciousness, the location of vascular stenosis is closely related to the clinical symptoms, however, there is no further discussion for the number,extent,the collateral compensation,intervene and prognosis of stenosed vascular.In order to find and clarify the stenosis of cerebral blood vessels of patients with brief loss of consciousness, and to give the necessary intervention to the factors that can be controlled, this study select 30 TIA patients who are accompanied by brief loss of consciousness to compare the number of stenosed blood vessels,the stenosis degree,the compensation and the inducements with another 30 TIA patients who aren't accompanied by brief loss of consciousness, and discuss the relationship between brief loss of consciousness and cerebral vascular stenosis. Furthermore, we follow up these 60 patients for one month to one year to observe if the symptoms recurred after the intervention of medication or surgical treatment and medication. The single-factor results are as follows: it is significantly different from the aspects of the location and number of stenosed blood vessels,the compensation,the inducements and sex difference for the TIA patients who are or aren't accompanied by brief loss of consciousness. However, there shows no significant differences between the single circulation and the mixed circulation, and there is no significant difference of the degree of stenosed blood vessels,the curative effect between single medication and surgical treatment adding to medication. And then, we make Logistic regression analysis for the factors which are significantly different in single factor analysis.The Logistic regression analysis shows:(1) The location of stenosed blood vessels, the impossibility of appearance of brief loss of consciousness in patients with bilateral arteries stenosis increased nearly 3.934 time.(2) The inducement, the impossibility of appearance of brief loss of consciousness in patients with obvious inducements increased nearly 3.655 time.In this study, the number of stenosed blood vessels,the compensation and sex difference are excepted in the process of Logistic regression analysis, but we can't say these factors don't have relation to brief loss of consciousness. So we come to conclusions as follows: for the TIA patients represented as brief loss of consciousness, bilateral blood vessels is often involved, commonly there are obvious inducement that resulting in the hypo-perfusion of hemisphere or brain stem, the male patients is more than female patients, and bilateral carotid diseases are more likely represented as brief loss of consciousness than unilateral diseases.Some conclusions from this study do not accord with the common phenomenon theoretically or clinically. For example, in our study, brief loss of consciousness resulting from post-circulation seems not to be much familiar than ante-circulation; mixed circulation involved seems not to be more likely to lead to the attack of loss of consciousness than single circulation involved; and there is no significant difference of the degree of stenosed blood vessels,curative effect between single medication and surgical treatment adding to medication. Such conclusions may attribute to the limited time for studying and the not–enough number of cases. It is better to make a large number of sample prospective study for much authentic conclusions.The significant sense of this study rests with the elaborate study of the factors of brief loss of consciousness. It makes the neurological physician pay more attention and know more about this uncommon but important factor for brief loss of consciousness, and give the patients the most correct diagnosis and therapy.In a word, for the TIA patients represented as brief loss of consciousness, bilateral blood vessels is often involved, commonly there are obvious inducement that resulting in the hypo-perfusion of hemisphere or brain stem, the male patients is more than female patients, and bilateral carotid diseases are more likely represented as brief loss of consciousness than unilateral diseases. So for the patients especially male patients represented as brief loss of consciousness clinically, if there are inducements such as tire,vomiting,diarrhea and hypotension, etc, except for the reasons such as cardiopathy,hypo-glucose and so on, it is very important to do correlative examination of cerebral vascular to clarify the cerebral vascular stenosis as soon as possible and to give the correct intervention in time, in order to reduce the rate of recurrence,stroke,disability and even mortality.