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The related main theme: A. Stroke and Cerebral vascular disorders

DISTRIBUTION OF CEREBRAL INFARCTION AND STENOSIS OF INTRA- AND EXTRACRANIAL ARTERIES IN YOUNG ADULTS

Authers:

Delgermaa  Tsagaankhuu, PhD, MD 1, 2 , Baigalmaa  Gongor, MD 3 , 
1 Mongolian National University of Medical Sciences, School of Medicine, Department of Neurology
2 Mongolia-Japan Hospital
3 Third Central Hospital, Department of Neurology
Corresponding Author:

Tsagaankhuu  Guntev

keywords: Young Adults, Stroke, Cerebral Ischemia, Risk factors, Carotid stenosis
Abstract for original article

OBJECTIVES /BACKGROUND:
The distribution of cerebral infarction and stenosis of intra- and extracranial arteries may vary with age-group and gender. This study was conducted to clarify the risk factors and characteristics of cerebral infarction and stenosis of vessels in young adults.

MATERIAL and METHOD:
This was a prospective study, from October 2015 to July 2020, of 100 patients below 50 years diagnosed with acute cerebral infarction. Patient characteristics were compared according to sex (61 males and 39 females) and age group (29 patients were below 34 years and 71 patients were 35–49 years). Characteristics of acute cerebral infarction were studied by DWI-diffusion weighted MRI imaging. Stenosis of intra- and extracranial arteries was diagnosed by duplex sonography, head and cervical magnetic resonance angiography (MRA).

RESULT:
Leading causes for cerebral infarction in the young patients were hypertension (71%), smoking (57%), dyslipidemia (45%), diabetes (33%), and migraine with aura (25%). Lacunar Infarction was most common in our patients (33%). Partial anterior circulation infarction was predominant in males (45.9% vs 38.5 %; P < 0.05) and posterior circulation infarction in females (23.1% vs 11.5 %; P< 0.05). Small artery atherosclerosis was found in 33% of cases, with a higher prevalence in patients of the 35–50 years age-group. Intracranial stenosis was more common than extracranial stenosis, and middle cerebral artery stenosis was most prevalent (38.9%). Stenosis in the anterior circulation was more frequent than in the posterior circulation (P < 0.001).

DISCUSSION:
In these young patients, hypertension, smoking, dyslipidemia, diabetes, and migraine with aura were common risk factors. Intracranial stenosis was most common, particularly in the middle cerebral artery.


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