The effect of ischemia-related leukoaraiosis on the conscious disturbance after stroke / 中华流行病学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the effect of leukoaraiosis on conscious disturbance in patients with acute cerebral infarction.</p><p><b>METHODS</b>A follow-up study including 138 patients with acute cerebral infarction matched with the diagnostic criteria of the Forth Cerebrovascular Disease Conference, were carried out. Patients were divided into two groups, using MRI to estimate the white substance process around cerebral ventricle, including 78 of them with leukoaraiosis and 60 without leukoaraiosis were followed up using Glasgow coma scale scores and England OCSP classification in 1 month, 3 month and 6 month after onset.</p><p><b>RESULTS</b>The independent factors of conscious disturbance included leukoaraiosis (OR = 5.294, 95% CI 1.451-19.318), and OCSP classification (TACI and POCI especially) (OR = 14.489, 95% CI 4.121-50.934). At the initial, the first month and the third month of the stroke episodes, significant difference (P < 0.05) was noticed when using Glasgow coma scales, and the scales in leukoaraiosis group was lower than the control.</p><p><b>CONCLUSION</b>TACI and POCI in OCSP classification were independent risk factors of conscious disturbance, and leukoaraiosis was also the independent factor. The incidence of conscious disturbance after stroke in patients with leukoaraiosis were lower than in that without leukoaraiosis. On the other hand, the degree of conscious disturbance was more serious and slower than those without leukoaraiosis, suggesting that the effect of leukoaraiosis was duplicate for conscious disturbance. Because patients with leukoraiosis had tolerance of chronic cerebral ischemia. The number of patients with conscious disturbance after stroke was fewer relatively. Leukoaraiosis had inactive effect for amelioration of conscious disturbance after three months of the episode. The grouping of OCSP played a primary while leukoaraiosis playing a secondary role, despite the patients with or without conscious disturbance after stroke.</p>