Clinical and imaging features of symptomatic middle cerebral artery occlusion in different regions / 中风与神经疾病杂志

ABSTRACT

@#Objective　To analyze the clinical and imaging characteristics of cerebral infarction patients with unilateral middle cerebral artery occlusion (MCAO),and to explore the pathogenesis of cerebral infarction and the related factors of hemorrhage transformation in different parts of MCAO.Methods　A total of 159 MCAO patients with acute cerebral infarction were divided into proximal MCAO group and distal MCAO group according to the location of occlusion.The clinical and imaging characteristics of the two groups were compared,and the independent risk factors of MCAO hemorrhagic transformation (HT) in different locations were analyzed by a multivariate logistics regression analysis method.Results　The proportion of hypertension and hyperlipidemia in proximal MCAO group was higher than that in distal MCAO group (P<0.05),the proportion of atrial fibrillation was significantly lower than that of distal MCAO group (P<0.01).The proportion of atherosclerotic type in proximal MCAO group was higher than that in distal MCAO group(P<0.01).The proportion of infarction involving basal ganglia and hemorrhage transformation (HT) in distal MCAO group was higher than that in proximal MCAO group (P<0.05),binary logistic regression analysis showed that different occlusion location of MCA and whether basal ganglia was involved were independent risk factors for hemorrhage transformation after infarction (P<0.05).Conclusion　Proximal MCAO cerebral infarction is mostly caused by atherosclerotic aorta,while distal MCAO cerebral infarction is mostly caused by cardiogenic embolism.Patients with distal MCAO infarction involving basal ganglia are prone to hemorrhage transformation,which may be related to reperfusion injury.