Lipoprotein abnormalities in the pathogenesis of cerebral infarction and transient ischemic attack.

HDL-cholesterol levels were determined by a heparin-Ca precipitation method in 89 survivors of cerebral infarction (CI) (75 males, 14 females) and 14 patients with transient ischemic attacks (TIA) (8 males, 6 females). The mean values of HDL-cholesterol concentration and HDL:LDL-cholesterol ratio for both sexes of CI patients were significantly lower than those of the healthy controls (37 males, 14 females). These values for CI patients were significantly lower than in patients with various diseases excluding cardiovascular disease, hepatic disease, hyperlipidemia, diabetes mellitus and degenerative disorders of the nervous system (46 males, 43 females). In patients with TIA, these differences were statistically significant only for men. Based on the patient's history, clinical signs and symptoms and the findings of computerized tomography and 4-vessel angiography, male CI patients were divided into 2 sub-groups, CI believed to be in the distribution of a perforating artery and CI in the distribution of a cortical artery; it was found that the HDL-cholesterol level and HDL:LDL-cholesterol ratio were significantly lower in the cortical artery group than in the perforating artery group, suggesting that these lipoprotein abnormalities may play a part in the pathogenesis of CI, particularly of the cortical artery area infarction.