Abstract
We evaluated the clinical subtypes and background factors of stroke in nine hemodialyzed patients with brain infarction in comparison with 19 hemodialyzed patients with brain hemorrhage. Mean age at the time of occurrence of brain infarction tended to be higher than the age at the time of occurrence of brain hemorrhage (66.3 years vs 63.1 years). The mean interval between the start of hemodialysis therapy and the occurrence of stroke was also longer than among the patients with brain hemorrhage (77.2 months vs 56.0 months). The brain infarction mortality rate was lower (22.2%) than that of brain hemorrhage (76.2%). According to the clinical classification of the National Institute of Neurological Disorders and Stroke, five patients had massive atherothrombotic infarction in the middle or posterior cerebral artery and four patients had cardioembolic infarction. There were no cases of lacunar infarction in our case series. Three of the five patients with atherothrombotic infarction had massive infarctions produced by hemodynamic mechanisms. Background factors consisted of hypertension in five patients (55.6%), heart disease in five (55.6%), diabetes mellitus in four (44.4%), and arrhythmia in one (11.1%). Heart disease was noted in two patients with cardioembolic infarction and three patients with atherothrombotic infarction. There were significant differences between the frequency of heart disease and cigarette smoking in the hemodialyzed patients with brain infarction and brain hemorrhage.
