Clinical Analysis Of Silent Cerebral Infarction Among Those First Attacked By Acute Cerebral Infarction

Objective: To observe the prevalence, the risk factors,clinical manifestations, brain magnetic resonance imaging (MRI)features and clinical significance of silent cerebral infarct-tion(SCI)among those first attacked by acute cerebral infar-cttion.Methods: A total of130cases of acute cerebral infarctionare hospitalized in the Second Clinical Medical College ofJilin University starting from March2011to December2012.Except for previous cerebrovascular disease, head trauma,spaceoccupying, liver and kidney diseases, all patients are thefirst occurrence of the lack of neurological symptoms and signs,and are diagnosed in accordance with the SCI diagnosticcriteria developed in the Fourth National CerebrovascularDisease Conference. On the basis of brain MRI, they are dividedinto the study group(both acute cerebral infarction respon-sibility and non-responsibility lesions)88cases, including50male and38female cases, and the control group(only acutecerebral infarction responsebility lesions)42cases, incl-uding32male and20female cases. Ask in detail about the patient’s medical history, physical examination, and theparallel blood glucose, blood lipids, electrocardiogram, brainMRI, head and neck vascular ultrasound check. Know clearlyabout the cerebrovascular disease risk factors, includingage,smoking,drinking history,blood lipids,hypertension,bloodglucose,atrial fibrillation,atherosclerotic plaque and art-erial stenosis.The thesis is to have a statistical analysis ofthese risk factors, compare the risk factors and clinicalsignifaicance between the two groups, to summarize and analyzethe clinical manifestations and brain MRI features of the thestudy group.Results:1. Of the patients first attacked by acute cerebral infar-ction, SCI prevalence rate is67.7%;2. Gender: Of the patients first attacked by acute cerebralinfarction, male SCI prevalence rate is61.0%while female’sis79.2%;higher in women than in men (P <0.05);Age: In the study group,for the patients whose age is <60years, the prevalence is49.3%，while those whose age is≥60years, the prevalence is89.8%; in control group, the formerprevalence is50.7%and the latter one is10.2%; of the patientswhose age is≥60years, SCI prevalence is higher than those whose age is <60years (P<0.05).3. Of those who suffer from smoking, alcohol consumption,hypertension, diabetes, hyperlipidemia and atrial fibril-ation, the prevalence is respectively55.7%、28.4%、55.7%、23.9%、56.8%、2.3%in the study group, while in the control group,the prevalence is respectively54.8%、40.5%、42.3%、16.7%、64.3%，7.1%. The prevalence showed no significant differencebetween the two groups (P>0.05). As a contrast,for those whosuffer from arterial stenosis and unstable atheroscleroticplaques, the prevalence is54.5%and75%in the study group,35.7%and54.8%in control group. There is a significantdifference in the prevalence (P<0.05) with the study groupprevalence higher distinctively than the control group.4. Clinical manifestations: SCI patients mainly havenon-specific symptoms and signs instead of having exactlocalizing symptoms and signs of nervous system. In this study,the accompanied symptoms are as follows: headache, dizziness,light-headedness, subjective paresthesia; lack of concent-ration, memory loss and decline in calculating ability;depression and anxiety, etc. Most patients have more than twoor more symptoms combination.5. In total,382non-responsibility lesions are found in the study group, of which, there are127in basal ganglia,96in corona radiate,65in internal capsule,32in thalamus,23in brainstem,7in cerebellum and32in brain lobes. Thefollowing are the number of the lesions with different diameter:lesion diameter≤1.5cm,327(85.6%),1.5cm<lesions≤3.0cm,47(12.3%),3.0cm<lesion≤5.0cm,8(2.1%).Conclusion: The prevalence of silent cerebral infarction ishigh among all the patients who are first attacked by acutecerebral infarction; women and people whose age is≥60yearsare more prone to suffer from silent cerebral infarction;patients who have artery stenosis or unstable atheroscleroticplaques tend to be attacked by silent cerebral lesions; silentcerebral infarction patients mainly have non-specific symptomsand signs instead of having exact localizing symptoms and signsof nervous system. Lacunar infarction accounts for most of thesilent cerebral lesions. The distribution of lesions are morecommon in the basal ganglia,the corona radiate and internalcapsule.