File Download
  Links for fulltext
     (May Require Subscription)
  • Find via Find It@HKUL
Supplementary

Conference Paper: Ischaemic stroke related to branch artery disease: a missing link?

TitleIschaemic stroke related to branch artery disease: a missing link?
Authors
KeywordsMedical sciences
Issue Date2010
PublisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk
Citation
The 15th Medical Research Conference (MRC 2010), Hong Kong, 16 January 2010. In Hong Kong Medical Journal, 2010, v. 16 suppl. 1, p. 30, abstract no. 43 How to Cite?
AbstractINTRODUCTION: Clinicians and researchers often classify atherosclerotic cerebral infarctions into large artery atherothrombotic disease (LAD) and small artery lacunar infarction (LACI), but this system of ‘dichotomisation’ cannot account for a substantial proportion of stroke cases. Twenty years ago, a third mechanism for cerebral infarction - branch artery disease (BAD) - was proposed. However, this concept was understudied and still remains an obscure entity. METHODS: Stroke patients admitted under the Neurology Unit of Queen Mary Hospital over a 24- month period were studied retrospectively. Patients with ischaemic stroke presumably due to atherosclerotic disease were classified according to their imaging +/– clinical findings into three groups: LAD, BAD, and LACI. Patients with BAD were further categorised into five BAD stroke syndromes based on radiological criteria. Clinical characteristics, vascular risk factors, results of vascular workup, and outcome among the various stroke subgroups were compared. RESULTS: A total of 720 patients with a diagnosis of stroke were admitted during the study period, including 123 LAD (17% of all stroke patients or 33% of all studied patients), 147 BAD (20% or 40%), and 102 LACI (14% or 27%). Among the BAD patients, the number of cases involving Heubner’s artery, lenticulostriatal arteries, anterior choroidal artery, thalamoperforating/geniculate arteries or paramedian pontine infarction were 0, 47, 45, 15 or 40 (0, 32, 31, 10 or 27%), respectively. Patients with BAD were the youngest among the three groups. As compared to LAD patients, BAD patients had lower NIHSS scores, were less often diabetic, and carotid stenosis was less common, while stenosis of the intracranial arteries were more frequently seen in BAD as compared to LACI patients. Mean follow-up period was 1085 days, and outcome of BAD patients was intermediate between LAD and LACI. Comparison of variables among the BAD stroke syndromes showed that they were a homogenous group of conditions. CONCLUSION: Despite being a rarely applied concept, BAD is the most prevalent subtype of ischaemic stroke in our study. The homogeneity among the BAD syndromes suggests they might represent a distinctive stroke entity. Although patients with BAD and LACI had similar degrees of neurological deficits on presentation, outcome in the former group was significantly worse than the latter.
Persistent Identifierhttp://hdl.handle.net/10722/126451
ISSN
2015 Impact Factor: 0.887
2015 SCImago Journal Rankings: 0.279

 

DC FieldValueLanguage
dc.contributor.authorKwan, MWMen_HK
dc.contributor.authorMak, Wen_HK
dc.contributor.authorChan, KHen_HK
dc.contributor.authorCheung, RTFen_HK
dc.contributor.authorHo, SLen_HK
dc.date.accessioned2010-10-31T12:29:20Z-
dc.date.available2010-10-31T12:29:20Z-
dc.date.issued2010en_HK
dc.identifier.citationThe 15th Medical Research Conference (MRC 2010), Hong Kong, 16 January 2010. In Hong Kong Medical Journal, 2010, v. 16 suppl. 1, p. 30, abstract no. 43en_HK
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/126451-
dc.description.abstractINTRODUCTION: Clinicians and researchers often classify atherosclerotic cerebral infarctions into large artery atherothrombotic disease (LAD) and small artery lacunar infarction (LACI), but this system of ‘dichotomisation’ cannot account for a substantial proportion of stroke cases. Twenty years ago, a third mechanism for cerebral infarction - branch artery disease (BAD) - was proposed. However, this concept was understudied and still remains an obscure entity. METHODS: Stroke patients admitted under the Neurology Unit of Queen Mary Hospital over a 24- month period were studied retrospectively. Patients with ischaemic stroke presumably due to atherosclerotic disease were classified according to their imaging +/– clinical findings into three groups: LAD, BAD, and LACI. Patients with BAD were further categorised into five BAD stroke syndromes based on radiological criteria. Clinical characteristics, vascular risk factors, results of vascular workup, and outcome among the various stroke subgroups were compared. RESULTS: A total of 720 patients with a diagnosis of stroke were admitted during the study period, including 123 LAD (17% of all stroke patients or 33% of all studied patients), 147 BAD (20% or 40%), and 102 LACI (14% or 27%). Among the BAD patients, the number of cases involving Heubner’s artery, lenticulostriatal arteries, anterior choroidal artery, thalamoperforating/geniculate arteries or paramedian pontine infarction were 0, 47, 45, 15 or 40 (0, 32, 31, 10 or 27%), respectively. Patients with BAD were the youngest among the three groups. As compared to LAD patients, BAD patients had lower NIHSS scores, were less often diabetic, and carotid stenosis was less common, while stenosis of the intracranial arteries were more frequently seen in BAD as compared to LACI patients. Mean follow-up period was 1085 days, and outcome of BAD patients was intermediate between LAD and LACI. Comparison of variables among the BAD stroke syndromes showed that they were a homogenous group of conditions. CONCLUSION: Despite being a rarely applied concept, BAD is the most prevalent subtype of ischaemic stroke in our study. The homogeneity among the BAD syndromes suggests they might represent a distinctive stroke entity. Although patients with BAD and LACI had similar degrees of neurological deficits on presentation, outcome in the former group was significantly worse than the latter.-
dc.languageengen_HK
dc.publisherHong Kong Academy of Medicine Press. The Journal's web site is located at http://www.hkmj.org.hk-
dc.relation.ispartofHong Kong Medical Journalen_HK
dc.rightsHong Kong Medical Journal. Copyright © Hong Kong Academy of Medicine Press.-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectMedical sciences-
dc.titleIschaemic stroke related to branch artery disease: a missing link?en_HK
dc.typeConference_Paperen_HK
dc.identifier.emailMak, W: makwaiwo@hotmail.comen_HK
dc.identifier.emailChan, KH: koonho@hku.hken_HK
dc.identifier.emailCheung, RTF: rtcheung@hku.hken_HK
dc.identifier.emailHo, SL: slho@hku.hk-
dc.identifier.authorityChan, KH=rp00537en_HK
dc.identifier.authorityCheung, RTF=rp00434en_HK
dc.identifier.authorityHo, SL=rp00240en_HK
dc.description.naturepublished_or_final_version-
dc.identifier.hkuros174978en_HK
dc.identifier.volume16en_HK
dc.identifier.issuesuppl. 1en_HK
dc.identifier.spage30, abstract no. 43en_HK
dc.identifier.epage30, abstract no. 43-
dc.publisher.placeHong Kong-
dc.description.otherThe 15th Medical Research Conference; Department of Medicine, The University of Hong Kong, Hong Kong, 16 January 2010. In Hong Kong Medical Journal, 2010, v. 16 suppl. 1, p. 30, abstract no. 43-

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats