Gorelick P B, Chatterjee A, Patel D, Flowerdew G, Dollear W, Taber J, Harris Y
Department of Neurology (Stroke, Alzheimer, and Neuroepidemiology Services), Michael Reese Hospital and Medical Center, School of Public Health (Epidemiology and Biometry Program), University of Illinois, Chicago, Chicago, IL.
Stroke. 1992 Jun;23(6):804-11. doi: 10.1161/01.str.23.6.804.
We compared cranial computed tomography findings among 58 multi-infarct dementia index cases and 74 multi-infarct control subjects without cognitive impairment to identify potential determinants of multi-infarct dementia.
The cranial computed tomography records of acute ischemic stroke patients with a history of multiple cerebral infarcts were compared to determine the number, location, and size of cerebral infarcts; the pattern of infarction; brain volume loss; and the degree of white matter lucency, sulcal enlargement, and ventricular enlargement. Multi-infarct patients were divided into two groups: 1) index cases were defined as those with multi-infarct dementia as defined by the Diagnostic and Statistical Manual of Mental Disorders, edition 3 (DSM-III) criteria; and 2) control subjects were defined as those multi-infarct patients without dementia or multi-infarct dementia according to DSM-III criteria.
Overall, multi-infarct index cases had more cerebral infarcts, more cortical and subcortical left hemisphere infarcts, higher mean ventricular volume to brain volume ratio, more extensive enlargement of the body of the lateral ventricles and cortical sulci, and a higher prevalence of white matter lucencies. Among multi-infarct cases and control subjects the most frequent site of infarction was the subcortical region, and the most frequent pattern of infarction was lacunar. Stepwise logistic regression analysis examined cranial computed tomography as well as other factors and showed that level of education, stroke severity, left cortical infarction, and diffuse enlargement of the left lateral ventricle were the best overall predictors of multi-infarct dementia.
Level of education, stroke severity, and left hemisphere infarction may be predictors of multi-infarct dementia.
我们比较了58例多发梗死性痴呆指数病例与74例无认知障碍的多发梗死对照受试者的头颅计算机断层扫描结果，以确定多发梗死性痴呆的潜在决定因素。
比较有多次脑梗死病史的急性缺血性卒中患者的头颅计算机断层扫描记录，以确定脑梗死的数量、位置和大小；梗死模式；脑容量损失；以及白质透明度、脑沟增宽和脑室扩大的程度。多发梗死患者分为两组：1）指数病例定义为符合《精神疾病诊断与统计手册》第3版（DSM-III）标准的多发梗死性痴呆患者；2）对照受试者定义为根据DSM-III标准无痴呆或多发梗死性痴呆的多发梗死患者。
总体而言，多发梗死指数病例有更多的脑梗死、更多的皮质和皮质下左侧半球梗死、更高的平均脑室体积与脑体积比、更广泛的侧脑室体部和皮质沟增宽，以及更高的白质透明度患病率。在多发梗死病例和对照受试者中，最常见的梗死部位是皮质下区域，最常见的梗死模式是腔隙性。逐步逻辑回归分析研究了头颅计算机断层扫描以及其他因素，结果显示教育程度、卒中严重程度、左侧皮质梗死和左侧侧脑室弥漫性扩大是多发梗死性痴呆的最佳总体预测因素。
教育程度、卒中严重程度和左侧半球梗死可能是多发梗死性痴呆的预测因素。
