Analysis Of The CTA Of Head And Neck Vessels And Risk Factors In Youth Infarction

Objective: To explore the CTA characters of artery of youth infarction,understand the characteristics of CISS typing,to investigate the factors that may exist of the youth stroke,provided primary and secondary prevention for young high-risk groups。Methods:278 young patients with cerebral infarction were studied in department of neurology of the Dalian Central Hospital from January 1,2013 to January 1,2017.All patients were matched with the 2010 Guidelines for the Chinese Diagnosis and Treatment of Acute Ischemic Stroke,they were confirmed diagnoses by DWI examination confirmed cerebral infarction.General parameters were studied,including gender,age,TIA or stroke history,history of hypertension,history of diabetes,history of coronary heart disease,family history of cardiovascular and cerebrovascular disease,family history of hypertension,family history of diabetes,smoking and drinking history.Laboratory parameters were studied,including blood routine,coagulation function,blood glucose,blood lipid,homocysteine,uric acid,the detection part of patients C reactive protein and anti phospholipid antibody.According to the clinical demand,CTA examination,and CISS typing.The above data were collected retrospectively to study the characteristics of CTA and the distribution of risk factors in young adults with cerebral infarction.Results :1.The young adult group comprised 5.54%(278/5018)of patients of all ages admitted for stroke.87.41% acute young adults cerebral infarction patients were male.15.82%acute young adults cerebral infarction patients were female,the ratio of male to female was 5.52:1.The age of onset was 18~45 years old and the mean age was 38.27±5.36 years old.2.The young group of intracranial artery stenosis in 108 cases(40.45%),extracranial vascular lesions in 67 cases(25.09%),intracranial or extracranial vessels were involved in 44 cases(16.48%);the elderly group of intracranial vascular lesions in 90 cases(30%),extracranial vascular lesions in 106 cases(35.33%),intracranial or extracranial vessels were involved in 68 cases(22.67%);The incidence of intracranial vascular occlusion or stenosis in young adults was higher than that in the elderly group,the difference was statistically significant(x 2=6.79,0.01 < P < 0.05).152 young adults had intracranial atherosclerosis,17 young adults had anterior cerebral artery occlusion or severe stenosis,78 young adults had middle cerebral artery occlusion or stenosis,19 young adults had posterior cerebral artery occlusion or stenosis,40 young adults had vertebral basilar artery occlusion or stenosis,84 young adults had carotid atherosclerosis,and 23 young adults had carotid atherosclerosis.There were 376 existing vascular stenosis or occlusion,including severe stenosis or occlusion in 186 cases,moderate stenosis in 59 cases,mild stenosis in 131 cases.The top three were middle cerebral artery,carotid artery and vertebral artery.3.The CISS typing results of cerebral infarction in young adults:there were 136 cases(48.92%)of large artery atherosclerosis,43 cases(15.47%)of cardiogenic stroke,54 cases(19.42%)of perforating artery type,7 cases(2.52%)of other causes,38 cases(13.67%)of unknown etiology.The proportion of large atherosclerosis was the highest.4.In young stroke patients,147 cases(53.03%)had history of hypertension,80 cases(28.79%)had history of diabetes,42 cases(15.15%)with history of TIA or stroke,78 cases(28.03%)with family history of stroke,61 cases(21.91%)had family history of hypertension,44 cases(19.51%)had family history of diabetes,191 cases(68.94%)with smoking history,107 cases(38.64%)had drinking history,2 cases with pregnancy,1 cases with drug abusers.The laboratory examinations showed that 200 cases(71.21%)suffered from abnormal lipid metabolism,79 cases(28.42%)suffered from hypercholesterolemia,97 cases(34.89%)suffered from hypertriglyceridemia,137 cases(49.28%)suffered from low density lipoprotein,130 cases(46.76%)suffered from high density lipoprotein decreased,53 cases(19.06%)suffered from apolipoprotein A increased,36 cases(12.95%)suffered from apolipoprotein A increased,111 cases(40.15%)suffered from high-homocysteine,80 cases(28.79%)suffered from hyperuricemia.Conclusion1.Male predominance existed the percentage of stroke in young adults is higher.2.The vascular lesions in young patients with cerebral infarction were mainly distributed in intracranial vessels,middle cerebral artery is the predilection site.By CISS typing,the main cause is atherosclerosis(LAA).