The Analysis Of Risk Factors, Pathogenesis And Willis Circle Of Cerebral Watershed Infarction In Chinese Patients

Part One:The Analysis of the Risk Factors and pathogenesis of Cerebral Watershed infarction in Chinese patientsObjective By analyzing the risk factors of Cerebral Watershed infarction (CWI) in Chinese patients, we aim to investigate the pathogenesis and provide evidence for the diagnosis, treatment and secondary prevention.Methods A total of 578 patients with cerebral infarction were included in our study. Patients with cerebral watershed infarction were divided into three subtypes (internal, external and mixed CWI). We compared the CWI group with non-cerebral watershed infarction (non-CWI) group. The clinical data as well as vascular images of these groups was analyzed.Results There was no difference between these groups in age, sex, hypertension, diabetes, circulation disorder (embolism), history of stroke and drinking, LDL, TC, TG, FIB, stenosis of vertebral basilar artery and posterior cerebral artery. More patients suffered from hyperfibrinogenemia in internal and mixed CWI. The rates of hyperlipidemia in external CWI and smoking history as well as circulation disorder (low blood volume) in mixed CWI had risen while the mean value of HDL-c in mixed-CWI decreased. Obviously, more stenoses were found in CWI and the incidence of MCA stenosis was as high as 56.7%. The stenosis incidence of ACA in external CWI and carotid in internal CWI was higher statistically than non-CWI.Conclusion Cerebral watershed infarction in Chinese patients is mainly associated with middle cerebral artery stenosis, the pathogenesis of its subtypes is also different from each other.Part two:Willis circle in cerebral watershed infarction:a study based on CT angiographyObjective To explore the unique relationship between Willis circle and cerebral watershed infarction in Chinese population.Methods Analyze the cerebral CT angiography of 471 non-cerebral watershed infarctions and 93 cerebral watershed infarctions(CWI) (including External CWI and Internal CWI) distinguished by Magnetic Resonace Imaging (Diffusion Weighted Imaging included) in Department of Neurology of our hospital and compare the collateral circulation variations, types and integrity of Willis circle between these groups.Results There is no obvious difference between these groups except the prevalence of Uni-FTP(Unilateral "fetal type of the Posterior cerebral artery") in E-CWI(36.4%,p<0.05) and Bi-FTP in I-CWI(0%,p<0.05).Conclusion FTP is probably an unique risk factor in Chinese CWI patients compared to non-CWI.