The Clinical Research Of Cerebral Hemorrhage Combined With Brain Ischemia

Objective:To study the changes in magnetic resonance imaging of spontaneousintracerebral hemorrhage, explore the morbidity of cerebral hemorrhage patients withischemic stroke by using the MRI, research the pathogenesis、predilection site、associated risk factors，and explore the importance of prevention of ischemic strokeafter cerebral hemorrhage.Materials and Methods:Extracted68patients with cerebral hemorrhage were enrolled hospital and hadCT、MRI、MRA、SWI examination successively within2~3weeks after the outbreakof the disease. Then we analysed the imaging, collected the clinical data and observedthe disease outcome. The same period we collected120cases of cerebral infarction,statistic the prevalence of cerebral hemorrhage history. By using SPSS.17.0software,The risk factors were analysed by using univariate analysis, the variables screenedstatistically significant which were then analysed by logistical regression.Results:The ischemic changes after cerebral hemorrhage has33cases, the total incidencerate is43.5%, which was found in six cases by CT, MRI could showed larger andclearer focus of ischemia than CT. The ischemic changes after cerebral hemorrhageare visible in the basal ganglia, near the lateral ventricles, semi-oval center, brainstem,occipital, corpus callosum, but more common in the basal ganglia. The univariateanalysis demonstrated there were significant differences in age, high blood sugar,high blood pressure, alcohol consumption, family history of stroke, atrial fibrillationbetween A group（with ischemic changes）and B group（without ischemic changes）（P<0.05）, while no statistically differences could been found in smoking, highcholesterol and atherosclerotic plaque between2groups（P>0.05）. The logistic regression analysis showed that the ischemia wans significantly independentlassociated respectively with age (OR=3.949, P=0.042<0.05), high blood sugar(OR=6.378, P=0.032<0.05), coronary heart disease with atrial fibrillation (OR=7.722, P=0.025<0.05), family history of cerebrovascular disease (OR=12.648, P=0.012<0.05).Conclusion:1. Magnetic resonance imaging is sensitive for cerebral ischemic changes, andcan detect ischemic lesions in cerebral hemorrhage patients.2. The ischemic changes after cerebral hemorrhage in this research are visible inthe basal ganglia, near the lateral ventricles, semi-oval center, brainstem, occipital,corpus callosum, but more common in the basal ganglia. The acute cerebral infarctionafter cerebral hemorrhage were located near the hematoma or distant parts of the area,Consider not cause corresponding symptoms in symptom concealed in hematomaadjacent parts of the new onset ischemia was the site of cerebral hemorrhage; distantareas of the brain infarcts are much smaller and has little effect on the majorfunctional areas, showed no clinical symptoms.3. Acute cerebral infarction after cerebral hemorrhage mainly due to the basicvascular stenosis with cerebral edema, excessive blood pressure and cerebralvasospasm; in the another hand, through the use of MRI the chronic ischemic brainchanges can be found in the cerebral hemorrhage patients like white matterosteoporosis, vascular stenosis, and old lacunar infarcts, and these are mainly due tothe risk factors like high blood pressure, diabetes and other long-term chronic effects.4. Age, high blood sugar, coronary heart disease (atrial fibrillation), history ofcerebrovascular disease are independent risk factors for cerebral ischemia.