Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
Clinical Study on Ischemic Cerebrovascular Diseases in the Aged
Toshihiko IwamotoHideyo KatsunumaYukihiko MaehataKazuta YunokiGoro Araki
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1986 Volume 23 Issue 4 Pages 406-412

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Abstract

To determine the characteristics of ischemic cerebrovascular diseases in the aged, 429 patients with ischemic neurological deficit, divided into four groups by decades, were studied with regard to clinical signs, CT findings and angiographic findings. Group I (49 years old or less) consisted of 50 patients, group II (50-59 years old) 97 patients, group III (60-69 years old) 161 patients, and group IV (70 years old or more) 121 patients. About half of the patients in each group were hypertensive. Diabetes mellitus was present in 21% of group III while atrial fibrillation occurred in 25% of group IV. The most commonly encountered clinical sign was hemiparesis or hemiplegia, which increased with age from 24% in group I to 39% in group IV. In group I, 40% of the patients did not show abnormal CT findings, while infarction of the basal ganglia and cortical region were seen in 34% and 18% of this group, respectively. Angiographic abnormalities such as stenosis, occlusion and/or early venous filling were seen in only 30%. In group II angiography demonstrated abnormalities in 38% of the patients, while CT indicated the basal ganglia lacunae in 41%. In group III CT revealed infarction of the cortical area in 32% while that of the basal ganglia occured in 34%. In group IV, infarction of these regions occured at the same frequency of 31%. Infarction of the cortical region was frequently caused by embolism, which tended to increase with age. In group IV large and medium-sized infarctions were present in 17%. Angiography demonstrated pathological abnormalities in 43% of group III and 49% of group IV. The above findings suggested that the high frequency of lacunae and embolism in aged patients was casually associated with arteriosclerosis and atrial fibrillation, increasing with age. The prevention of cerebral infarction in aged patients with atrial fibrillation is therefore an important task for the physician.

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© The Japan Geriatrics Society
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