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characteristics and risk factors for ischemic stroke patients with posterior circulation infarcts and non-posterior circulation infarcts
Source publication
Background
Cervical spondylosis is one of the extrinsic factors causing vertebral artery stenosis. Several case studies have reported compression of the vertebral artery induced by cervical osteophytes that has resulted in posterior circulation infarcts (POCI). However, to the best of our knowledge, no studies have yet analyzed differences in the r...
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Background:
Grading of degeneration of the cervical spine is of great clinical value, considering the vast amount of radiological investigations that are being done with this query. Despite the fact that Computed Tomography (CT) is frequently used in clinical practice there is today no user-friendly and reliable scoring system for assessment of ce...
Citations
... In addition to the increased risk of stroke, spondylosis increases the risk of vertebral artery dissection in the general population, which may compound the risk to jiujitsu athletes [33]. Displacement of the vertebral arteries leads to a change in blood flow leading to an increased risk of posterior circulation (PC) stroke [34]. Dissections of the vertebral arteries typically occur due to manipulation, trauma, or positional (hyperextension or stretching) of the neck [22]. ...
... Studies in the literature generally aim to investigate acute ischemic processes related to static stenosis in the vertebrobasilar system or chronic ischemic changes secondary to stenosis. Therefore, in the literature, acute vertebrobasilar insufficiency developed in conditions such as trauma, dissection, and chronic ischemic processes due to stenoses caused by atherosclerotic changes in the vertebral lumens or stenoses developed due to external compression of the lumen predominate (22)(23)(24)(25)(26)(27)(28). In our study, we attempted to detect ischemic processes caused by vertebrobasilar insufficiency secondary to dynamic and frequent compression of the vertebral arteries due to neck movements, although no critical stenosis was observed on static examination. ...
Aim: This study aimed to determine whether degeneration of the cervical vertebrae and paravertebral structures may be a predisposing factor for ischemic processes by disrupting hemodynamics in the posterior system through mechanical effects on the vertebral arteries. Material and Method: We retrospectively analyzed 180 patients who underwent cervical magnetic resonance imaging (MRI), cervical computed tomography (CT), carotid-vertebral neck CT angiography (CTA), cranial computed tomography (CT), and cranial MRI performed between January 2017 and October 2023. Of the patients, 90 (44 females, 46 males) had mild degeneration or no significant degeneration with a mean age of 58 years, and 90 (40 females, 50 males) had significant cervical spondylosis (CS) with a mean age of 64 years. The radiological findings of the patients were analyzed statistically, and p
... Non-rheumatic aortic valve disorders, angina pectoris, and cerebral infarction, appear in group 21, along with spondylosis, other spondylopathies, and senile cataracts in men. Cervical spondylosis (CS) have previously been associated with a higher risk of posterior circulation infarcts 38 , and with acute coronary syndrome 39 . Unspecified stroke, hypotension, and oesophageal varices, all in men, are in the adjacent group 20, along with hypo-osmolarity and hyponatraemia, and ulcer of lower limbs in women. ...
Data-driven classifications are improving statistical power and refining prognoses for a range of respiratory, infectious, autoimmune, and neurological diseases. Studies have used molecular information, age of disease incidence, and sequences of disease onset (“disease trajectories”). Here we consider whether easily measured risk factors such as height and BMI can usefully characterise diseases in UK Biobank data, combining established statistical methods in new but rigorous ways to provide clinically relevant comparisons and clusters of disease. Over 400 common diseases were selected for study on the basis of clinical and epidemiological criteria, and a conventional proportional hazards model was used to estimate associations with 12 established risk factors. Comparing men and women, several diseases had strongly sex-dependent associations of disease risk with BMI. Despite this, a large proportion of diseases affecting both sexes could be identified by their risk factors, and equivalent diseases tended to cluster adjacently. This included 10 diseases presently classified as “Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified”. Many clusters are associated with a shared, known pathogenesis, others suggest likely but presently unconfirmed causes. The specificity of associations and shared pathogenesis of many clustered diseases, provide a new perspective on the interactions between biological pathways, risk factors, and patterns of disease such as multimorbidity.
... Cerebral arterial stenosis, including intracranial and/or extracranial artery stenosis, is characterized by narrowed arteries that supply blood to the brain, resulting in cerebral hypoperfusion. 4 Patients with severe cerebral artery stenosis run a higher risk of distal embolization, hemodynamic changes, and sudden vascular occlusion. [5][6][7] Alzheimer's disease (AD) is associated with decreased cerebral blood flow. It was found that AD cases displayed a degree of cerebral artery occlusion and that there was a positive Zhao et al correlation between the degree of arterial stenosis and neurofibrillary tangle (NFT) score. ...
Aim
Urinary kallidinogenase (UK) has shown promise in improving cerebral perfusion. This study aimed to examine how UK affects cognitive status and serum levels of amyloid betas (Aβs) 1-40 and 1-42 in patients with cerebral arterial stenosis.
Methods
Ninety patients with cerebral arterial stenosis were enrolled, of whom 45 patients received UK + conventional treatment (UK group), and 45 patients received conventional treatment alone as control group. Cognitive status and Aβ1-40 and Aβ1-42 serum levels were determined before treatment and at 4 weeks and 8 weeks after treatment.
Results
At 4 weeks after treatment, cognitive status in patients treated with UK clearly improved accompanied by Aβ1-40 serum levels decreasing while there was no change of Aβ1-42. Cognitive status in patients receiving UK continued to improve, Aβ1-40 serum levels declined further as well as Aβ1-42 serum levels began to decrease dramatically at 8 weeks after treatment.
Conclusion
UK could improve cognitive status and decrease both Aβ1-40 and Aβ1-42 serum levels to prevent ischemic cerebral injury, which represents a good option for patients with cerebral arterial stenosis.
The importance of quantifying the distribution and determinants of multimorbidity has prompted novel data-driven classifications of disease. Applications have included improved statistical power and refined prognoses for a range of respiratory, infectious, autoimmune, and neurological diseases, with studies using molecular information, age of disease incidence, and sequences of disease onset (“disease trajectories”) to classify disease clusters. Here we consider whether easily measured risk factors such as height and BMI can effectively characterise diseases in UK Biobank data, combining established statistical methods in new but rigorous ways to provide clinically relevant comparisons and clusters of disease. Over 400 common diseases were selected for analysis using clinical and epidemiological criteria, and conventional proportional hazards models were used to estimate associations with 12 established risk factors. Several diseases had strongly sex-dependent associations of disease risk with BMI. Importantly, a large proportion of diseases affecting both sexes could be identified by their risk factors, and equivalent diseases tended to cluster adjacently. These included 10 diseases presently classified as “Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified”. Many clusters are associated with a shared, known pathogenesis, others suggest likely but presently unconfirmed causes. The specificity of associations and shared pathogenesis of many clustered diseases provide a new perspective on the interactions between biological pathways, risk factors, and patterns of disease such as multimorbidity.
Background and aims:
Cervical spondylosis (CS) is reported to be associated with vertebrobasilar insufficiency. However, few cohort studies have investigated the association between CS and posterior circulation ischemic stroke.
Methods:
The study cohort comprised 27,990 patients aged ≥18 years with a first diagnosis of CS. The controls consisted of patients with propensity score matched for age, sex, and comorbidities at a ratio of 1:1. We investigated the relationships of CS with ischemic stroke and all-cause mortality. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). The average follow-up duration was 6.13 (SD = 3.18) and 6.07 (SD = 3.19) years in the CS and non-CS cohorts, respectively.
Results:
The mean age of CS patients and non-CS patients was 54.9 ± 13.4 and 55.1 ± 14.9 years. Fifty-eight point five percent of CS patients and 59.2% of non-CS patients were women. CS patients were 1.46 folds more likely to develop a posterior circulation ischemic stroke (95% CI, 1.23-1.72) than non-CS patients. CS patients with myelopathy exhibited a 1.50-fold risk (95% CI, 1.21-1.86) of posterior circulation ischemic stroke compared with non-CS patients; CS patients without myelopathy were at a 1.43-fold risk (95% CI, 1.18-1.73) of posterior ischemic stroke compared with non-CS patients. The risk of posterior ischemic stroke was non-significant between non-CS patients and CS patients who had received spinal anterior decompression (adjusted HR, 1.66; 95% CI, 0.78-3.52), while receiving posterior decompression was associated with a 4.23-fold risk of posterior ischemic stroke (95% CI, 1.05-17.0).
Conclusions:
This population-based study showed that CS is associated with an increased risk of posterior circulation ischemic stroke. Surgical posterior decompression was associated with the highest risk of posterior ischemic stroke.
