DSA Analysis And Etiology Exploring In 86 Young Adults Stroke

Objective: To analyze DSA findings and explore the etiology and risk factors in young adults stroke.Methods: 86 young cases with stroke,whose age was less than or equal to 45 years old, admitted to the Department of Neurology,the Second Affiliated Hospital of Dalian Medical University from January 2001 to December 2010 were enrolled in this study.All cases met the 1995 criteria of classification of cerebrovascular disease and were confirmed by computerized tomography (CT) and (or) magnetic resonance imaging (MRI).There was no angiography contraindications. Following factors were statistically analyzed: age,gender,onset state,symptoms,history of past illness,personal history,family medical history,cranial CT,cranial MRI,DSA,ECG,Echocardiography,Neck vascular ultrasound. ESR,RF,ASO and immunological indexes were examined in past cases when necessary.DSA data in all 86 cases,confirmed by CT/MRI,was retrospectively analyzed.The possible reason and risk factors of the stroke was explored.Results:1.65 of 86(75.58%) cases were hemorrhagic stroke, 21 of 86(24.42%) cases were ischemic stroke. Hemorrhagic stroke in young cases were more common. In this study,including 35 (53.85%) ICH, 30 (46.15%) SAH.60 of 86(69.77%) cases were male and 26 of 86(30.23%) cases were female.The ratio of male to female is 2.31:1.Male predominance existed the percentage of stroke in young cases.2.Reasons of hemorrhagic stroke in 65 young cases were various,including aneurysm in 22 cases(33.85%),arteriovenous malformations in 13 cases(20%), cavernous hemangioma in 8 cases(12.31%), Moyamoya disease in 4 cases(6.15%)and atherosclerosis in 3cases(4.62%). No definite etiological factor was found in 15 cases(23.08%). 3.Reasons of ischemic stroke in 21 young cases were also different,including atherosclerosis in 9 cases(42.86%), Moyamoya disease in 5 cases(23.81%), cerebral arteritis,congenital vascular stenosis and FMD all in 1 case(4.76%).No definite etiological factor was found in 4 cases(19.05%).4.In 86 young cases with stroke, 32 (37.21%) had history of smoking, 18 (20.93%) had history of drinking and hypertension, 13 (15.12%) suffered from hyperlipemia, 6 (6.98%) suffered from diabetes,3(3.49%) had family history.Conclusions:1.Hemorrhagic stroke is more common and male predominance existed the percentage of stroke in young cases.2.The main etiological factors of hemorrhagic stroke in young cases are aneurysm,arteriovenous malformations,cavernous hemangioma and Moyamoya disease. Atherosclerosis are few. About one-fifth cases have no definite etiological factor.3.The main etiological factors of ischemic stroke in young cases are atherosclerosis and Moyamoya disease. Other etiological factors(such as cerebral arteritis,congenital vascular stenosis,FMD)are few. About one-fifth cases have no definite etiological factor.4.The main risk factors of stroke in young cases are smoking,hypertension,drinking,hyperlipemia,diabetes and family history.