Analysis Of Factors Related To Microemboli In Cases With Acute Ischemic Cerebrovascular Syndrome

Background and purpose Transient ischemic attack(TIA) and cerebralinfarction are the different stages of dynamic process of cerebral lesion, sharinga similar underlying pathophysiology: cerebral ischemia. Therefore, acuteischemic cerebrovascular syndrome (AICS) can describe a spectrum oftransient cerebral ischemic events without diffusion weighted imaging (DWI).Patients with AICS should be accepted tests as soon as possible for the purposeof assessing the risks and intervention, such as transcranial Doppler(TCD)microemboli monitoring technology. It has been confirmed that MES was anindependent risk factor for ischemic cerebrovascular disease. We will discussfactors related to microemboli in cases with AICS, as well as the relation withDWI and ABCD score system.Methods Outpatient and inpatient, diagnosed as AICS by the departmentof Neurology of First Bethune Hospital of Jilin University, were selected fromSeptember2010to January2012.The patient were monitored MES byTCD(<72h).We recorded age, gender, past history(hypertension, diabetes,coronary heart disease),smoking and drinking history, lipids,TCD, Carotidartery ultrasound and DWI. All patients were divided into MES positive andnegative groups.Results220patients,176male and44female, average age54±12yearsold. The MES positive rate was34.6%.There was no statistical significancebetween two groups about age, gender, hypertension, diabetes and coronaryheart disease, as well as drinking. There is a statistically significant relationshipin daily cigarette consumption and smoking index except smoking time.Compared lipids between the two groups, only Low-density lipoprotein chole- sterol(LDL-C) was significant differences, other than glycerol-lesters, cholesterol, high density lipoprotein cholesterol, or lipoprotein a-JS.There was no significant difference on the lipid levels of the indicators.Between the two groups, with or without vascular stenosis and the degree ofstenosis were significant differences. Positive rate of DWI in MES positivegroup was significantly higher than that of MES negative group; corticalinfarction of MES positive group occurred significantly higher than that ofMES negative group, both had significant differences. Between the two groupsfor risk stratification of ABCD, neither ABCD2nor ABCD~3had significantdifference, but ABCD~3was significant difference.conclusions The study might indicate that the patients with smoking orhigh LDL-C had MES tendency. What`s more, the patients with stenosis ofresponsibility artery were prone to microemboli, and the higher the degree ofstenosis, the higher the positive rate of microemboli. The patients with micro-emboli and clinical presentations of TIA had high tendency to cerebralinfarction. Cortical small infarction on DWI inclined to artery~artery embolism. Compared with ABCD2and ABCD~3, ABCD~3-I was a moreaccurate prediction of microemboli risk for AICS patients.