Stroke: In the general population, what is the difference between the risk factors for old or new cerebral infarction?

Cerebral infarction in the elderly is a common finding on magnetic resonance (MR) images, most of which do not cause the signs or symptoms of a clinical diagnosis of stroke
.

Some scholars believe that this may be related to the size and location of the infarct

diagnosis

As a systematic review has shown, in cohort studies, the results on the relationship between cerebral infarction and risk factors vary greatly, and only age and hypertension have been shown to be important risk factors
.

There may be a clear association between cerebral infarction and heart failure, carotid and coronary artery disease

Hypertension However, the relationship between cerebral infarction and potential risk factors (including gender, tobacco consumption, dyslipidemia, atrial fibrillation, and diabetes ) remains unclear

Stroke

In this study, Sigurdur Sigurdsson et al.
assessed the relationship between prevalence and eventual cerebral infarction in subcortical, cortical, and cerebellar regions identified by MRI and risk factors for blood vessels , arteriosclerosis, and embolism
.

Research data comes from a large, population-based cohort of older men and women participating in the AGES-Reykjavik study (age gene/environmental susceptibility-Reykjavik study)

Blood vessel

They were based on the longitudinal AGES (age, genetic/environmental susceptibility) of the population-Participants in the Reykjavik study (n=2662, average age 74.
6±4.
8) underwent brain magnetic resonance imaging at baseline and an average of 5.
2 years later
.

And evaluated the number and location of cerebral infarction (epidemic and accidental)

31% of study participants had an epidemic cerebral infarction, and 21% had a new cerebral infarction within 5 years
.

The prevalent subcortical infarcts and hypertension (PRR, 2.

Prevalence and occurrence of cortical infarction are related to carotid plaque (PRR, 1.
8 [95% CI, 1.
3-2.
5] and IRR, 1.
9 [95% CI, 1.
3-2.
9], respectively), atrial fibrillation and prevalent cortical infarction Significantly correlated (PRR, 1.
8 [95% CI, 1.
2-2.
7])
.

Risk factors for epidemic cerebellar infarction include hypertension (PRR, 2.
45 [95% CI, 1.
5-4.
0]), carotid plaque (PRR, 1.
45 [95% CI, 1.
2-1.
8]) and migraine with aura ( PRR, 1.
6 [95% CI, 1.
1-2.
2])
.

The occurrence of cerebellar infarction is only related to any migraine (IRR, 1.

The significance of this study lies in the findings: The risk of subcortical infarction tends to increase with risk factors for small vessel diseases such as high blood pressure and diabetes
.

The risk of cortical infarction tends to increase with the atherosclerosis/coronary artery process, while the risk of cerebellar infarction has more mixed factors

The risk of subcortical infarction tends to increase with small vessel disease risk factors such as high blood pressure and diabetes

Original Source:
  Sigurdsson S, Aspelund T, Kjartansson O, et al.

Cerebrovascular Risk-Factors of Prevalent and Incident Brain Infarcts in the General Population: The AGES-Reykjavik Study.
Stroke.
Published online November 23, 2021:STROKEAHA.
121.
034130.
doi :10.
1161/STROKEAHA.
121.
034130

Cerebrovascular Risk-Factors of Prevalent and Incident Brain Infarcts in the General Population: The AGES-Reykjavik Study.

 

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