Kim Ganghyun, Vitti Emilia, Stockbridge Melissa D, Saver Jeffrey L, Hillis Argye E, Faria Andreia V
Department of Neuroscience, Johns Hopkins University, Baltimore, MD, USA.
Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Heliyon. 2023 Apr 5;9(4):e15287. doi: 10.1016/j.heliyon.2023.e15287. eCollection 2023 Apr.
Considering the anatomical features of Middle Cerebral Artery (MCA) bifurcation, larger emboli are more likely to enter the inferior division over the superior division. Since emboli of cardiac origin are larger on average than emboli of arterial origin, we hypothesize that the infarcts in temporal and parietal lobes are more likely associated to atrial fibrillation than those in the frontal lobes, therefore occurring more often in populations with higher incidence of atrial fibrillation, such as male (compared to women) and white (compared to black) patients.
We included 197 patients with MCA "temporoparietal predominant" infarcts and 105 with "frontal predominant" infarcts. Variations between stroke location (frontal or temporoparietal), sex, and race were examined via Chi-square test.
Male patients were more likely than female patients to be afflicted by temporoparietal strokes versus frontal strokes, while white patients had greater likelihood than black patients to be afflicted by temporoparietal strokes versus frontal strokes. Patients with confirmed diagnosis of atrial fibrillation display more temporoparietal strokes compared to frontal strokes.
Temporoparietal MCA ischemic strokes occur more frequently in male and white patients: populations with known increased incidence of atrial fibrillation. In addition, population-specific anatomical characteristics of the MCA bifurcation might favor the larger cardiac emboli to enter the inferior division and cause temporoparietal infarcts. This association can help guide search for the most likely etiology of infarcts.
考虑到大脑中动脉（MCA）分叉处的解剖学特征，较大的栓子更有可能进入下分支而非上分支。由于心脏来源的栓子平均比动脉来源的栓子更大，我们推测颞叶和顶叶梗死比额叶梗死更可能与心房颤动相关，因此在心房颤动发病率较高的人群中更常发生，如男性（与女性相比）和白人（与黑人相比）患者。
我们纳入了197例以颞叶和顶叶为主的MCA梗死患者以及105例以额叶为主的梗死患者。通过卡方检验研究中风部位（额叶或颞叶和顶叶）、性别和种族之间的差异。
与额叶中风相比，男性患者患颞叶和顶叶中风的可能性高于女性患者，而与额叶中风相比，白人患者患颞叶和顶叶中风的可能性高于黑人患者。确诊为心房颤动的患者与额叶中风相比，颞叶和顶叶中风更多见。
颞叶和顶叶MCA缺血性中风在男性和白人患者中更常见：这些人群已知心房颤动发病率增加。此外，MCA分叉处特定人群的解剖学特征可能有利于较大的心脏栓子进入下分支并导致颞叶和顶叶梗死。这种关联有助于指导寻找梗死最可能的病因。
