Difference in the Location and Risk Factors of Cerebral Microbleeds According to Ischemic Stroke Subtypes / 대한뇌졸중학회지

BACKGROUND AND PURPOSE: The location of cerebral microbleeds (CMBs) may differ according to ischemic stroke subtype, and the underlying pathomechanism may differ by their location. Here, we investigated the characteristics of CMBs according to various ischemic stroke subtypes to verify this issue. METHODS: Patients with acute ischemic stroke were consecutively included. The presence of CMBs was determined by gradient echo image sequence. The distribution of CMBs was classified as deep, lobar, or diffuse (both deep and lobar). The prevalence, risk factors, and distribution of CMBs were compared among patients with different stroke subtypes. Factors associated with the distribution of CMBs were investigated. RESULTS: Among the 1033 patients included in this study, ischemic stroke subtypes were classified as large artery atherosclerosis (LAA; n=432), small vessel occlusion (SVO; n=304), and cardioembolism (CE; n=297). The prevalence of CMBs was highest in patients with SVO (40.5%), followed by CE (33.0%) and LAA (24.8%; P<0.001). The locations of CMBs was different according to subtype (P=0.004). CE [odds ratio (OR)=1.85 (1.02-3.34); P=0.042] and the use of antithrombotics [OR=1.80 (1.10-2.94); P=0.019] were associated with lobar CMBs, and old age [OR=1.02 (1.00-1.04); P=0.015] and hypertension [OR=1.61 (1.08-2.40); P=0.020] were associated with deep CMBs. CONCLUSIONS: CMBs were frequently located in the lobar area in patients with CE. Previous use of antithrombotic agents is associated with lobar CMBs. The pathogenic mechanism of CMB may differ according to ischemic stroke subtype and location.

Induced Hypertension Using Phenylephrine in Patients with Acute Ischemic Stroke: A Case Report / 대한구급학회지

Decreased cerebral perfusion is associated with a poor prognosis for a patient suffering from acute ischemic stroke. Induced hypertension may improve the cerebral perfusion and stroke symptoms. However, there is not enough clinical evidence to support this therapy and it is rarely performed in daily practice. Here we report three patients with acute ischemic stroke and cerebral hypoperfusion who were successfully treated with induced hypertension using intravenous phenylephrine. Phenylephrine infusion may be a treatment option for patients suffering from acute ischemic stroke and cerebral hypoperfusion.