脳梗塞および一過性脳虚血発作発症例のHITS予測因子に関する検討

抄録

Method: To elucidate the predictive factors of high intensity transient signals(HITS), we analyzed 88patients with cerebral infarction or transient ischemic attack(TIA). We performed transcranial Doppler monitoring from the middle cerebral artery(MCA) or basilar artery for 30 min. Results: HITS were detected in 9 (13%) of 67 patients with cereberal infarction, and in 8(38%) of 21 patients with TIA. Overall HITS prevalence was 19%. Multivariate logistic regression analysis revealed that only the infarct/TIA subtype was a significant predictive factor of HITS (p=0.047), and that neither age, sex, TIA, high intensity signals (HIS) found on diffusion-weighted MR imaging (DWI), risk factors for atherosclerosis, the timing of HITS detection, nor medication was significantly linked to HITS. Among the infarct/TIA subtypes, HITS were detected more frequently in patients with hemodynamic/arteriogenic embolic ischemia caused by stenosis in the carotid artery or MCA than in those with cardiogenic embolic and intracranial thrombotic ischemia. Affected patients were significantly young, and cortical/subcortical spotty HIS found on DWI were more frequent in the HITS-positive group. Conclusion: Cerebral ischemia of the hemodynamic/arteriogenic embolic subtype, an age of < 70yr, and cortical/subcortical spotty HIS found on DWI may be predictive factors of HITS.