Related Experiment Videos
Small subcortical infarcts and primary subcortical haemorrhages may have different risk factors
E Janssens1, F Mounier-Vehier, M Hamon
1Service de Neurologie B, Hôpital B., Lille, France.
Insights
Cerebrovascular risk factors differ between subcortical haemorrhages (SCH) and small subcortical infarcts (SSI). Arterial hypertension and alcoholism are key factors for SCH, while leukoaraiosis is linked to SSI.
Area of Science:
- Neurology
- Vascular Neurology
- Stroke Medicine
Background:
- Subcortical haemorrhages (SCH) and small subcortical infarcts (SSI) originate from changes in penetrating arteries.
- Understanding the distinct cerebrovascular risk factors for SCH and SSI is crucial for targeted prevention and treatment strategies.
Purpose of the Study:
- To compare cerebrovascular risk factors between patients diagnosed with primary SCH and patients diagnosed with SSI.
- To identify independent risk factors associated with each type of subcortical vascular event.
Main Methods:
- Retrospective analysis of 396 patients with first-ever stroke.
- Categorization of patients into SSI (n=108) and SCH (n=64) groups, allowing for co-existing conditions.
- Statistical comparison of demographic, clinical, and imaging data, including risk factors like hypertension, atrial fibrillation, alcoholism, and leukoaraiosis.
Main Results:
- Patients with SCH were younger, less likely to have atrial fibrillation or non-lacunar infarcts, but more prone to arterial hypertension and alcoholism.
- Independent predictors for SCH included alcoholism, arterial hypertension, and absence of significant internal carotid artery stenosis.
- Leukoaraiosis score was the sole independent predictor for SSI.
- Arterial hypertension was a significant risk factor in both groups, with higher prevalence in the SCH group.
Conclusions:
- Arterial hypertension and alcoholism are significant independent risk factors for SCH, whereas leukoaraiosis is associated with SSI.
- The development of SSI versus SCH may be influenced by a combination of risk factors, including alcohol consumption.
- Further research should investigate the specific characteristics of arterial hypertension in relation to these stroke subtypes.
Abstract:
Primary subcortical haemorrhages (SCH) and small subcortical infarcts (SSI) arise from changes in penetrating perforating arteries. The aim of this study was to compare cerebrovascular risk factors between patients with SCH and patients with SSI. Of 396 patients with a first-ever stroke (226 males; 170 females; median-age: 63), 108 had SSI, and 64 SCH, with or without subcortical infarcts co-existing. Patients with SCH were less likely to have current atrial fibrillation or associated non-lacunar infarcts, but they were more likely to have arterial hypertension (except after exclusion of patients with co-existence of SSI and SCH) and alcoholism, and they were significantly younger and had lower leukoaraiosis scores. The independent factors for SCH were alcoholism, arterial hypertension and lack of significant internal carotid artery stenosis. The only independent factor for SSI was leukoaraiosis score. Hypertension was the most important risk factor in both groups, but its prevalence was higher in the SCH group. Whether patients will develop SSI or SCH probably depends on associated risk factors such as alcohol consumption. Further studies should also take into account the characteristics of arterial hypertension.