The Effect Of Obstructive Sleep-related Disordered Breathing On The Cerebral Microbleeds In Cerebral Infarction Patients

Objective：To investigate the effect of obstrustive sleep apnea-hypopnea syndrome(OSAHS) on cerebral microbleeds(CMBs) in cerebral infarction patients.Methods：Patients with cerebral microbleeds’s acute cerebral infarction according tothe results of a susceptibility-weighted imaging (SWI) exam, were successivelychosen to undergo a polysomnogram(PSG). All patients were divided two group: AHIof less than5as non OSAHS group: AHI is equal or greater than5as OSAHS groupaccording to sleep apnea-hypopnea index (AHI). This study compared the clinical andradiological features of cerebral microbleeds between patients with OSAHS andpatients without OSAHS.Results：49patients were enrolled ultimately. Among them,27patients (55.1%)suffer from both cerebral infarction and OSAHS, and22patients (44.9%) havecerebral infarction but do not have OSAHS. A comparison of risk factors shows thathypertension, smoking history, and history of stroke are more prevalent in patientswith OSAHS than patients without OSAHS(P<0.05). Furthermore, the percentage ofsubclinical stroke in OSAHS patients and non-OSAHS patients are37.0%（10/27）and9.0%（2/22）(P<0.05)，respectively. The neurological imaging study reveals that thenumber of cerebral microbleeds in OSAHS group is more than non-OSAHSgroup(P<0.05)，77.8%of the focus of microbleeds in OSAHS patients is distributedin cortical-subcortical areas,55.6%in the basal ganglia area， and25.9%ininfratentorial area, whereas the percentages in non-OSAHS patients are50.0%,40.9%and50.0%，respectively，P<0.05. An analysis of the causes of cerebral infarctionreveals that40.7%of OSAHS patients also suffer from leukoaraiosis, and that48.1%of patients have two or more stroke causes. The percentages in non-OSAHS patientsare13.6%and18.2%（P<0.05），respectively.Conclusions：OSAHS may be a risk factor for cerebral microbleeds. For thosepatients who suffer from both cerebral infarction and OSAHS, the lesions of cerebralmicrobleeds is greater and wider. The cause of disease is also more complicated, andthe stroke recurrence is higher for these patients.