한림 뇌졸중 자료은행을 통한 혼합형 뇌졸중의 빈도와 임상양상

Abstract

Department of Neurology, Hallym University College of Medicine Background:“Mixed stroke”, ischemic infarction combined with intracerebral hemorrhage is not rare on brain imaging study of stroke patient. However, few studies addressed the prevalence or clinical characteristics of mixed stroke. We explored the incidence and clinical patterns of mixed stroke on large hospital-based stroke registry. Methods: We collect the clinical data and MR imaging from Hallym Stroke Registry Data Bank between October 1994 and February 2001. We defined mixed stroke as ischemic stroke combined with MR evidence of coexisting old ICH or hemorrhagic stroke combined with MR evidence of coexisting old infarct. Two neuroradiologists independently assessed MR imagings without the knowledge of clinical findings. Vascular risk factors of mixed stroke were compared with those of other ischemic stroke subtypes. Results: Of total 1984 cases, 121 cases(6.1%) were mixed stroke. The prevalence of mixed stroke in subtype of index stroke as followings: large artery atherosclerosis with previous hemorrhage(38/749, 5.2%); small vessel occlusion with previous hemorrhage(36/606, 5.9%); hemorrhagic stroke with previous ischemic stroke(26/157, 16.6%); cardioembolism with previous hemorrhage(3/134, 2.2%); Others & Undetermined(18/338, 5.3%). Hypertension were more frequent in mixed stroke than other ischemic stroke subtypes. Conclusions: In our study, the prevalence of mixed stroke was 6.1%, which should not be neglected. We speculated that underlying pathophysiology of mixed stroke may be related with hypertensive vasculopathy. Therefore, we suggest that antiplatelets or anticoagulant should be carefully used and that bloodpressure control should be strictly done in patierts with mixed stroke.