Comparison of Four Methods calculating Ankle Brachial Indexes for Coexistent Intracranial and Extracranial Artery Stenoses in the Patients with Ischemic Stroke

BACKGROUND: The ankle brachial index (ABI) is a useful screening tool for peripheral arterial disease. It has been documented that the cerebral atherosclerosis is more frequent in stroke patients with abnormal ABI than in those with normal ABI. The present study compared the different calculation methods of ABI for coexistent intracranial and extracranial arterial stenosis (IECAS) in ischemic stroke. METHODS: We reviewed the data of patients admitted for acute ischemic stroke or transient ischemic attack. The following four distinct ABIs were calculated: the ratio of the higher (ABI-H), lower (ABI-L), or either of the systolic blood pressures (SBPs) of the posterior tibial (ABI-PT) and dorsalis pedis (ABI-DP) arteries relative to the higher of the brachial SBP. We compared the values of these four ABI measures relative to the presence of any IECAS using receiver operating characteristic (ROC) curve analysis. RESULTS: ABI-H, ABI-L, ABI-PT, and ABI-DP were abnormal (≤ 0.9) in 19 (13.1%), 36 (24.8%), 29 (20%), and 30 (20.7%) of 145 patients, respectively. The area under the ROC curve was significantly larger for ABI-H, ABI-L, and ABI-DP than for ABI-PT for any type of IECAS. The extracranial stenosis was more frequent when any of the four ABIs was abnormal, while intracranial stenosis was not correlated with the four ABIs. The IECAS was more frequent for abnormal ABI-H and ABI-DP than for normal ABIs. CONCLUSIONS: Our studies suggested that ABIs based on a higher SBP of the PT or DP (i.e., ABI-H) are more strongly associated with the presence of IECAS than are those using the SBP of the PT (ABI-PT). Extracranial artery stenosis seems to be more strongly associated with ABI than is intracranial stenosis.

Comparisons of Life Quality between Chronic and Episodic Migraine Patients

BACKGROUND: In this study, the quality of life of patients with chronic and episodic migraine was compared using quality of life assessments tools, which included the MIDAS (migraine disability assessment) questionnaire and MSQoL (migraine-specific quality of life) questionnaire. METHODS: The investigation occurred from November 2005 to April 2006 for patients who visited the neurology department of hospital in because of headache. The patients for the question investigation consisted of 34 patients with chronic migraine (CM) and 48 patients with episodic migraine (EM). The diagnosis of migraines was obtained by the migraine criteria of the International Headache Society (IHS). RESULTS: In the comparisons of the MIDAS score in patients with CM and EM, the second question (reduced effectiveness at work/school), the fourth question (reduced effectiveness in housework), total scores (28+/-19.7 versus 12.0+/-10.1, p<.01), and the question A were higher in CM patients (51.2+/-20.1 versus 15.5+/-13.1, p<.01). MIDAS grade of CM patients were also higher than EM patients. In MSQoL score comparisons of CM and EM patients, three parts of life qualities, which are role-function restrictive, role-function preventive, and emotional function due to headache, and total score (61.9+/-11.7 versus 73.7+/-13.9, p<.01) was less in CM patients than EM patients. CONCLUSIONS: The study shows that life qualities of the patients with CM were significantly lower than of the patients with EM.