Microalbuminuria in non-diabetic patients with cerebral infacrtion

BACKGROUND: Microalbuminuria predicts cardiovascular events in diabetic and non-diabetic patients. But, few studies have addressed the relationship between microalbuminuria and cerebral infarction. We determined the incidence of microalbuminuria in non-diabetic subjects with cerebral infarction and investigated the relationship between urinary albumin excretion and risk factors of the stroke. METHODS: Urinary albumin excretion rate, 24 hours blood pressure monitoring, fasting serum lipid profiles, fibrinogen, fasting glucose, insulin and c-peptide were evaluated in 50 non-diabetic patients with acute cerebral infarction and matched 48 controls. RESULTS: Microalbuminuria was detected in 23 of 50(46%) patients with acute cerebral infarction and 4 of 48(8%) control subjects. Hypertension was present in 13 of 23(57%) microalbuminuric patients and 9 of 27(33%) non-microalbuminuric patients. In the microalbuminuric patients with cerebral infarction, diastolic blood pressure and fasting glucose were significantly greater than the control group. But, no difference in systolic blood pressure, lipid level, fibrinogen, fasting insulin and c-peptide level. CONCLUSIONS: The prevalence of microalbuminuria in patients with cerebral infarction was higher than controls and it was associated with increased diastolic blood pressure(DBP) and fasting blood glucose(FBS). Therefore, microalbuminuria is associated with thrombogenic cerebral infarction and it was partly mediated by DBP and FBS.

MR Imagings of Chronic Acquired Hepatic Failure

Neuroimaging of the brain is useful diagnostic evaluation of patients with hepatic encephalopathy msofar as it is able to exclude other causes of abno rmal mental status. Recently, changes of basal ganglia on MRI characteriwd by increased signal mtensity on Tl-weighted images were reported m patients with liver cirrhosis. Signal abnormality involves mainly the globus pallidus and seems to be specific for patients with chronic liver disease. Its pathogenesis and significance are obscure, and no pathological reports have been made. We experienced 3 cases of Chronic acquired hepatic failure whose MRI showed increased signal in-tensity in the basal ganglia on Tl-weighted imaging. Our findings su-ggest that basal ganglia signal abnormality could arise as a marker of brain impairment related to deposition of an unidentified paramagnetic substance or altered intracellular water relaxation.