Risk factors and etiological subtype analysis of brainstem infarctions

Abstract

Objective: To evaluate the features of risk factors and etiological subtypes of brainstem infarctions (BSIs) patients in China.

Methods: One hundred and ninety-nine cerebral infarction patients with brainstem involvement were categorized into five groups according to Trial of Org 10172 in Acute Stroke Treatment classification: large artery disease (LAD), cardioembolism (CE), small vessel disease (SVD), stroke of other determined etiology (SOE) or stroke of undetermined etiology (SUE). The risk factors and percentage of the different etiological subtypes were assessed.

Result: A total of 199 patients were enrolled in this study. The number and percentage of patients in SVD, LAD, SUE, CE and SOE were 77 (38.7%), 74 (37.2%), 25 (12.6%), 23 (11.6%) and 0, respectively. There were significantly different incidences of hypertension, diabetes and coronary heart disease (CHD) without atrial fibrillation (AF) among different stroke subtypes (P=0.006, P=0.002, P=0.016, respectively). Hypertension was more prevalent in LAD than in SVD and CE (P=0.001 and P=0.039, respectively) while the incidence of diabetes in LAD was higher than those in SVD and CE (P<0.001 and P=0.015, respectively). CHD without AF was more prevalent in CE than in SVD and LAD (P=0.044 and P=0.012, respectively). LAD was significantly associated with hypertension (OR=3.18, P=0.009) and diabetes (OR=2.84, P=0.003) in BSIs.

Conclusion: The pattern of etiological subtypes of BSIs in China has its own characteristics. It might result from the features of risk factors in Chinese patients.

Keywords: Acute stroke treatment; Atrial fibrillation; Brainstem infarctions; Etiology; Hypertension; Risk factors.