두개내 경동맥계 협착 및 폐색성 질환을 동반한 뇌졸중 환자의 장기 예후

Abstract

Background: The intracranial artery disease is a major cause of stroke and more prevalent than the extracranial artery disease, especially in Asian countries. However, there are limited data on the long-term prognosis and recurrence in acute stroke patients with steno-occlusive arterial disease in intracranial carotid system (SADICS). Methods: We identified cases with SADICS out of 1,030 acute stroke patients admitted to Hallym University Sacred Heart Hospital between March 1999 and June 2004. SADICS was defined as the stenosis more than 50% in diameter or the occlusion of main artery of the intracranial carotid system based on MRA. We followed up the cases with SADICS and determined a cumulative rate of mortality and recurrence with Kaplan-Meier survival analysis (median follow-up of 29.5months). Results: SADICS was found in 184 (20.2%) patients (mean age, 65.6 ¡¾ 11.8; male, 54.7%). Their risk factors included hypertension in 74.5%, diabetes in 33.2%, smoking in 31.0%, hyperlipidemia in 23.9% and previous stroke in 22.9%. The most common location of SADICS was the middle cerebral artery. Among 155 patients who were available to follow up at the time of investigation (February 2005), 150 (96.8%) patients had been under the medical managements for secondary prevention. The cumulative rates of death at 1, 2 and 5 years were 5.8%, 8.9%, and 19.4%, respectively. The cumulative rates of recurrent stroke at 1, 2 and 5 years were 7.8%, 13.8%, and 32.2%, respectively. Conclusion: The long-term prognosis of SADICS in our study was not comparable to the previous studies from other countries. This finding may be due to differences of the method and study population in each study.