Clinical Analysis In 109 Patients With Acute Brainstem Infarction

Objective: to analyze the clinical data,risk factors,initial symptoms,clinical manifestations,imaging findings and laboratory tests of patients with acute brainstem infarction,and to investigate the risk factors and clinical features of patients with progressive stroke of the brainstem infarction.Method:A total of 109 patients with acute brainstem infarction who were hospitalized in the Second Affiliated Hospital of Soochow University from February 2016 to February2017 were selected.All of them were in accordance with the diagnostic criteria of cerebral vascular disease,and were diagnosed by MRI.Their risk factors and clinical characteristics were analyzed.They were divided into progressive stroke of the brainstem infarction group(n = 33)and non progressive stroke of the brainstem infarction group(n = 76).The two groups of patients’ gender,age,past medical history,smoking and drinking history,Admission NIHSS(National Institute of Health stroke scale)score,pulmonary infection,hospitalization time,clinical manifestations,laboratory data and imaging features were analysised.SPSS l9.0 statistical software was used to compare the data of two groups of patients.The t test was used to compare the measurement data with the normal distribution.The rank sum test was used to measure the measurement data that do not conform to the normal distribution.And the chi square test was used to compare categorical variables.Results: In 109 patients with brainstem infarction,hypertension was the most common risk factor(89.0%),followed by hyperlipidemia(63.3%),diabetes history(56.9%),smoking history(24.8%),previous stroke history(23.0%).High temperature(T≥39℃)(P=0.014),pulmonary infection(P=0.014),elevated fibrinogen levels(P=0.024)and basilar artery stenosis(P=0.011)were possible risk factors for progressive stroke of the brainstem infarction.In this investigation,the initial symptoms with the frequency of occurrence was Dizziness or vertigo(35.8%),Limb weakness(28.4%),Articulation disorder(22.3%).In 109 patients with brainstem infarction,Limb weakness was the most common clinical symptoms and signs,followed by facial paralysis,Articulation disorder,tongue paralysis,Pathological sign,Dizziness,etc.The most common location ofinfarcts was pons(78.9%),followed by medulla oblongata(9.2%),midbrain(4.6%),Medulla oblongata and pons(3.7%),Pons and midbrain(3.7%).104 patients underwent vascular examination in this investigation and 78 cases(75%)had posterior circulation artery stenosis.There were 42 cases of Posterior cerebral artery stenosis,36 cases of vertebral artery stenosis,19 cases of basilar artery stenosis in this 78 patients.Conclusion:The common risk factors of brainstem infarction with the frequency of occurrence were hypertension,hyperlipidemia,diabetes mellitus,previous stroke history and smoking history.Dizziness or vertigo was the most common initial symptom of brainstem infarction and Limb weakness was the most common clinical symptoms and signs.The predilection sites of brainstem infarction were pons,medulla oblongata,midbrain.Typical crossover symptoms or signs of brain stem infarction were not common.The progressive stroke of the brainstem infarction occurs more easily at high temperature(T≥39℃)and pulmonary infection.Elevated fibrinogen levels and basilar artery stenosis were possible risk factors for progressive stroke of the brainstem infarction.