The Relative Research Between Vertebral Artery Dominance And Posterior Circulation Cerebral Infarction

Objective:With the acceleration of population aging in China,the proportion of stroke in the incidence of the disease increased year by year,especially in the posterior circulation cerebral infarction disability and mortality rate were obviously higher.Related to vascular risk factors of stroke in China based on the prevalence of hypertension,diabetes mellitus and hyperlipidemia was still growing,increasing stroke can cause huge economic burden to the society and family,had gradually become an important public health problem in our country,so we would strengthen the work of the primary and two level comprehensive prevention and stroke related research as soon as possible.With the continuous improvement and progress of neuroimaging technology,more and more scholars payed attention to the study of the cerebrovascular vascular variation or intracranial vascular malformations.Therefore,it was helpful to improve the prevention and treatment of posterior circulation stroke by studying the changes of blood vessels and the related risk factors of the posterior circulation artery system.Methods:Selection of acute cerebral infarction in the first hospital of Baoding city of the patients in this study were in line with the condition of entering the group and the head and neck vascular and MRI scan.The 326 patients in the group were divided into anterior circulation ischemic stroke(Anterior circulation ischemic stroke,ACIS)group of 217 cases and posterior circulation ischemic stroke group(Posterior circulation ischemic stroke,PCIS)in 109 cases.Collected patients were retrospectively analyzed the gender,age,hypertension,diabetes,hyperlipidemia,coronary heart disease,high homocysteine levels disease,history of TIA,such as information.The results of the patient’s cranial magnetic angiography images were classified according to the criteria of vertebral artery dominance,recorded the number of patients with vertebral artery dominance(Vertebral artery dominance,VAD)and non vertebral artery dominance in the anterior and posterior circulation infarction group,and the grade of VAD.Collected different posterior circulation infarcts and classified,namely the medulla oblongata and cerebellar hemisphere infarction of the lower posterior inferior cerebellar artery(Posterior inferior cerebellar artery,PICA),pontine infarction of basilar artery(Basilar artery,BA),superior cerebellar infarction of superior cerebellar artery(superior cerebellar artery,SCA),thalamus and occipital lobe infarction of the posterior cerebral artery(posterior cerebral artery,PCA).The measured data with normal distribution were expressed as mean ± standard deviation(x-±s),and the t test was used to compare the age of each group,and the other risk factors were compared by Chi-square test.Chi-square test was used to compare the incidence of each site in the VAD group and the control group,and to analyze the risk factors of cerebrovascular disease by Logistic.Study on the correlation between posterior circulation cerebral infarction patients and vertebral artery dominance,and the application of Logistic regression analysis showed that the independent risk factors of cerebral infarction is vertebral artery dominance in posterior circulation.The collected data were statistically analyzed by SPSS19.0 software,and P<0.05 was considered statistically significant.Results:In 326 patients with acute ischemic stroke,there were 125 cases(38.34%)in the vertebral artery dominant group(n = 201),and the non vertebral artery dominance group(61.66%)were 201 cases.Among the 217 cases of anterior circulation infarction group,the number of male and female cases were respectively 130 and 87 cases,the average age of the patients was in the range of 60.07±16.02 years old,and there were 72 patients with vertebral artery dominance(33.18%).There were 109 cases in the posterior circulation infarction group,male and female patients were 72 and 37 cases included in the study.The mean age of the patients was in the range of 59.46±16.41 years,and the vertebral artery dominance were 53 cases in all the patients(48.62%).The rate of vertebral artery dominance in the posterior circulation cerebral infarction group was significantly higher than that of the anterior circulation infarction group(48.62%VS33.18%,P<0.05).To analysis the incidence rate of vertebral artery dominance and the vertebral artery nondominance in ACIS and PCIS groups,compared with the control group,the Chi square value of dominant group was 7.32,and the P value was 0.007,which showed that the number of VAD cases in the posterior circulation cerebral infarction was significantly different from that of the anterior circulation cerebral infarction(P<0.05),It is confirmed that the posterior circulation cerebral infarction is closely related to the vertebral artery dominance.The statistical analysis of age,gender and hypertension,diabetes,smoking history,drinking history,hyperlipidemia,coronary heart disease in the ACIS group and the PCIS group were not statistically significant(P>0.05).The incidence of infarction in the basilar artery and posterior cerebellar artery in the vertebral artery dominance group was significantly higher than that in the control group.The P value were 0.005 and 0.049,respectively,and the difference was statistically significant.Multivariable Logistic regression showed that vertebral artery dominance(P=0.000),hyperhomocysteinemia(P=0.000),and previous TIA history(P=0.015)were independently associated with posterior circulation cerebral infarction.Conclusion:1.In all patients with ischemic stroke,the ratio of vertebral artery dominance of posterior circulation cerebral infarction was higher.Finally,the advantage of vertebral artery is the risk factor of posterior circulation cerebral infarction.2.The patients with vertebral artery dominance were more likely to occur the posterior circulation infarction in PICA and BA areas.The medulla oblongata and the lower part of cerebellar hemisphere infarction occurred in the side of vertebral artery nondominance,and pontine infarction appeared in the side of vertebral artery dominance.3.Vertebral artery dominance,high homocysteine,and TIA history were independent risk factors for posterior circulation cerebral infarction.4.It is possible to have a more positive and effective treatment for patients with vertebral artery predominance,hyperhomocysteinemia and TIA attack,which may be a impoint point to prevent recurrence of cerebral infarction.