Risk Factors Of Cerebral Hemorrhage Of Different Parts And Study On The Recovery Phase Dysmnesia

ObjectivesCerebral hemorrhage is a frequently-occurring and common disease that severely impairs the human health. In addition to the physical dysfunction, the cognitive disabilities including memory problems are important factors affecting the quality of life after cerebral hemorrhage. Therefore, the prevention and treatment of cerebral hemorrhage have been concerns in neuroscience community. However, the intracerebral risk factors of different parts and cognitive impairment characteristics are still unknown at present, which will affect the early detection and timely treatment. For this reason, this research aims to discuss the similarities and differences of intracerebral risk factors of different parts and damage features of different memory elements.Part1Clinical Research of Risk Factors for Cerebral Hemorrhage in Different Parts of BrainPurpose:To explore the risk factors for cerebral hemorrhage attackMethods:Ninety-seven cases of outpatient and inpatient patients with cerebral hemorrhage from the Neurology Department were selected from2012to2014, including36cases of basal ganglia hemorrhage,36cases of thalamic hemorrhage,25cases of lobar hemorrhage and100cases of healthy people over the same period. Survey collected demographic data, medical history, life style, and indicators of Triglyceride (TG), Total Cholesterol (TC), High Density Lipoprotein Cholesterol (HDL-C) and Low Density Lipoprotein Cholesterol (LDL-C).Results:1. Analysis of risk factors for cerebral hemorrhage1.1Univariate analysis of categorical variables Smoking, drinking and hypertension were risk factors for hemorrhagic stroke, and the difference was statistically significant compared to control group (P<0.05). As for gender, diabetes and coronary heart disease, there was no difference of statistical significance between cerebral hemorrhage group and control group (P>0.05).1.2Univariate analysis of continuous variables SBP and DBP were risk factors for hemorrhagic stroke, the difference was statistically significant compared to control group (P<0.05). HDL and TC were protective factors for cerebral hemorrhage (P<0.05). As for age, LDL and TG, there was no difference of statistical significance between cerebral hemorrhage group and control group(P>0.05).1.3Multivariate logistic regression analysis Drinking, hypertension and LDL were independent risk factors for hemorrhagic stroke (OR>1, P<0.05), TC was protective factor for cerebral hemorrhage (OR=0.25, P=0.000).2. Analysis of risk factors for cerebral hemorrhage in different parts of brain2.1Univariate analysis of categorical variables Smoking, drinking and hypertension were risk factors for basal ganglia hemorrhage and thalamic hemorrhage, the difference was statistically significant compared to control group(P<0.05). Smoking and drinking were risk factors for lobar hemorrhage, as for gender, diabetes and coronary heart disease, there was no difference of statistical significance between control group and cerebral hemorrhage subtype group (P>0.05).2.2Univariate analysis of continuous variables Age, SBP and DBP were risk factors for hemorrhagic stroke in basal ganglia, SBP and DBP were risk factors for hemorrhagic stroke in thalamus and lobar, the differences were statistically significant compared to control group (P<0.05). HDL was protective factor for basal ganglia hemorrhage and thalamic hemorrhage (P<0.05). TC was protective factor for hemorrhage in basal ganglia and lobar (P<0.05). As for TG, there was no difference of statistical significance between control group and cerebral hemorrhage subtype group (P>0.05).2.3Multivariate analysis of risk factors for cerebral hemorrhage in different parts of brain Hypertension and LDL were risk factors for basal ganglia hemorrhage, TC was protective factor for basal ganglia hemorrhage. Drinking and hypertension were risk factors for thalamic haemorrhage. Drinking was risk factor for lobar hemorrhage and TC was protective factor.Conclusions:Drinking and hypertension were independent risk factors for cerebral hemorrhage, and TC was protective factor. Different parts of brain had different risk factors, hypertension was risk factor for basal ganglia hemorrhage and deep thalamic hemorrhage, and drinking was risk factor for thalamic hemorrhage and lobar hemorrhage.Part2Clinical Research of Memory Disorders in Convalescence of Cerebral Hemorrhage in Different Parts of BrainPurpose:To explore the feature of memory impairment after cerebral hemorrhage in different parts, and provide the basis for early identification and intervention of memory impairment after cerebral hemorrhage and delay the onset of vascular dementia (VD).Methods:Wechsler Memory Scale (WMS), Wechsler Adult Intelligence Scale-Revised by China (WAIS-RC) vocabulary subtest and the Rey Auditory Verbal Learning Test were performed among25cases of basal ganglia hemorrhage,10cases of thalamic hemorrhage and50healthy cases in control groups. Memory score was compared separately of patients with basal ganglia hemorrhage, thalamic hemorrhage and healthy people in normal control group about basal ganglia hemorrhage, thalamic hemorrhage and left and right basal ganglia hemorrhage. Differences of gender, age and educational level had no statistical significance. Results:The differences between basal ganglia hemorrhage and normal control group were statistically significant (P<0.05) in memory indicators of short-term memory (1-100,100-1, cumulative, picture memories, visual recognition, visual regeneration, associative learning, tactile memory), working memory (recite), semantic memory (vocabulary test), delayed recall (short delay recall, long delay recall). The differences between thalamic hemorrhage and normal control group were statistically significant (P<0.05) in memory indicators of long-term memory (orientation), short-term memory (1-100,100-1, cumulative, picture memories, visual recognition, visual regeneration, associative learning, tactile memory), working memory (recite), semantic memory (vocabulary test), delayed recall (short delay recall, long delay recall). Associative learning ability was significantly lower in left basal ganglia hemorrhage than in right side (P<0.05). The visual recognition was significantly lower in right basal ganglia hemorrhage than in left side (P<0.01). As for semantic memory, there was no difference of statistical significance between left and right basal ganglia hemorrhage (P>0.05).Conclusions:Memory dysfunction still existed in convalescence of cerebral hemorrhage, and different parts of cerebral hemorrhage had different types of memory dysfunction.