Study On The Risk Factors Associated With Transient Ischemic Attack In Elderly Patients With Cerebral Microbleeds And The Features Of MRI

Objectives:To investigate the significance of cerebral microbleed (CMB) in clinical at aged patients with transient ischemic attack, analysis the influence of CMB related risk factors and distribution types, so as to provide information for clinical diagnostic value of CMB in transient ischemic attack, and provide reference for the improvement of treatment and prognosis in patients with stroke.Materials and Methods:From2011December to2012December, the transient ischemic attack (TIA) patients were collected in the Department of Radiology Central South University Xiangya Hospital, and collecting clinical data and MRI images were analyzed. The inclusion criteria is:(1) over60years of age;(2) the clinical diagnosis of transient ischemic attack;(3)of the activities of daily living scale (IADL) score>13. Exclusion criteria:(1)suffered from hemorrhagic cerebrovascular disease, dementia, Parkinson’s disease, head trauma, intracranial tumors and other possible effects of CMB and brain iron deposition disease of the central nervous system;(2) suffering from mental disease;(3) a drug or alcohol addiction or abuse;4) severe vision or hearing impairment;(5) the MRI check taboo.We collected the basic clinical data including sex, age of patients, height, weight, blood pressure, complications (hypertension, diabetes, coronary heart disease) disease; biochemical index including fasting blood glucose (Fasting blood-glucose, FBS), total cholesterol (Total Cholesterin, T-CHOL), glycerin three greases (Triglyceride, TG), high density lipoprotein protein (High Density Lipoprotein, HDL), low density lipoprotein (Low Density Lipoprotein, LDL); general cognitive function (mini mental state examination). All subjects were showed by brain MRI scan of Siemens Avanto magnetic resonance scanner, scanning sequences included axial T1weighted, T2weighted, axial FLAIR, axial T2weighted sagittal and axial SWI weighted sequence.Results:(1) The proportion of cerebral infarction in CMB positive group was higher than that of in CMB negative group, and MMSE score was significantly lower than that of in CMB negative group. Compared with CMB negative group and positive group of other clinical characteristics and MRI features, in addition to the number of CMB, age, high density lipoprotein cholesterol (HDL), the number of hypertension, lacunar infarct, PVH ang DWMH, there were significant differences. CMB negative group had lower age, higher HDL levels, and the cavity stem number. PVH and DWMH grading were low in CMB positive group.(2) According to the distribution of CMB types, lacunar infarction and signal level of cerebral white matter in CMB diffuse group were higher than that than that of lobar group and in deep structure group, but the level of HDL was no significant difference between groups.(3) The factors associated with the overall CMB occurs mainly include gender (male), high TG and severe PVH, OR were2.49,3.58and4.64; and the lobes of the brain type CMB factors associated with the development of serious PVH, OR value is7.01; and the deep structure of CMB associated factors for high TG, the OR value is6.80; and diffuse CMB associated factors for lacunar number and DWMH, OR values were9.4and7.88。Conclusions:1.TIA with CMB in elderly patients with cerebral infarction were larger proportion, which suggesting that CMB and is related to the degree of ischemic vascular disease.2. Gender (male), high TG and severe PVH is an independent risk factor for the occurrence of CMB. And the brain type CMB factors associated with the development of severe PVH; and the deep structure of CMB associated factors for high TG; and diffuse type CMB related factors forlacunar number and DWMH.