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Long-term prognosis for cerebral infarction in relation to brain circulation--a 7-year follow up study
Insights
Patients with reduced cranial blood flow (BF) after a cerebral infarction face a significantly higher long-term mortality risk. This study indicates decreased BF is a poor prognostic indicator, though stroke recurrence rates were similar between groups.
Area of Science:
- Neurology
- Cardiovascular Science
- Medical Prognostics
Background:
- Cerebral infarction, or stroke, is a leading cause of long-term disability and mortality.
- Cranial blood flow (BF) is a critical physiological parameter following ischemic events.
- The prognostic value of initial cranial BF in stroke survivors remains an area of investigation.
Purpose of the Study:
- To investigate the long-term prognostic significance of cranial blood flow (BF) in patients following cerebral infarction.
- To compare survival rates and stroke recurrence between patients with normal and subnormal cranial BF.
Main Methods:
- A 7-year prospective follow-up study involving 77 patients diagnosed with cerebral infarction.
- Cranial blood flow (BF) was assessed using the intravenous RISA method at the time of the initial stroke.
- Patients were categorized into normal and subnormal cranial BF groups, with annual re-examinations.
Main Results:
- Patients with subnormal cranial BF exhibited a significantly higher mortality rate (52.2%) compared to those with normal cranial BF (22.6%) over 7 years.
- The cumulative survival rate was consistently lower in the subnormal BF group, reaching statistical significance at 5 and 7 years.
- No significant difference in stroke recurrence rates was observed between the normal and subnormal cranial BF groups.
Conclusions:
- Decreased cranial blood flow (BF) following cerebral infarction is a significant indicator of poor long-term prognosis.
- Subnormal cranial BF is associated with increased overall mortality, independent of stroke recurrence.
- Cranial blood flow assessment may aid in identifying high-risk stroke survivors requiring closer monitoring.
Abstract:
Seventy-seven patients with cerebral infarction have been re-examined every year and followed for 7 years. Thirty-one patients had normal cranial blood flow (BF) and the remaining 46 had subnormal cranial BF, determined by the intravenous RISA method at the time of the original attack. During a 7-year follow up, 7 patients (22.6%) of the normal cranial BF group died; 3 of stroke and the remaining 4 from other causes, while 24 patients (52.2%) of the subnormal cranial BF group died; 13 of stroke and the remaining 11 of various diseases. The cumulative survival rate was consistently lower in the subnormal cranial BF group than the normal one. This difference reached statistical significance at 5 and 7 years of follow up. However, stroke recurrence did not differ significantly between the 2 groups. This suggests that a decreased cranial BF is an indicator of a poor long-term prognosis.