Journal of Korean Society of Geriatric Neurosurgery 2006;2(1):55-60.
Published online February 15, 2006.

Comparison of Risk Factors and Clinical Findings for Cerebral Infarction between Younger and Elderly Groups in a Single Center

Hyuk Jai Choi , Suk Keun Choi , Gook Ki Kim , Jun Seok Koh , Tae Sung Kim , Bong Arm Rhee , Young Jin Lim

Department of Neurosurgery, School of Medicine, Kyung-Hee University, Seoul, Korea

65세 이상의 뇌경색 환자와 65세 이하의 환자군에서의 뇌경색 위험인자와 임상양상의 비교

최혁재 · 최석근 · 김국기 · 고준석 · 김태성 · 이봉암 · 임영진

Abstract

objective: To compare risk factors and clinical findings in patients with cerebral infarction between groups aged over 65 years and under 65 years of age.   Malerials & Methods: From 1 Oct. 2003 to 31 Dec. 2004, the patients who were diagnosed with cerebral infarction by brain CT and/or brain MRI(n 190) were divided into two study groups, patients over 65 years old(n 91) and patients under 65 years old (n=99). Then, a retrospective comparative analysis of their subtypes of infarction, risk factors (sex, hypertension, DM, smoking, hyperlipidemia, obesity), clinical Findings and outcomes was done using medical records.   Results: Of these patients, 91 of them were over 65 years old and 99 were under 65 years old. The male th female was 115:75, and it was 52:39 in patients over 65 years old and 63:36 in patients under 65 years old. According to the NINDS (National institute of Neurological Disorder and Stroke) classifications, 17 patients (18.7%) were cardioembolic infarctions, 33 patients (36.3%) were athcrothrombotic infarctions in the clderly group and 27 patients (27.3%) were cardiocmbolic infarctions, 25 patients (25.3%) were ahterothrombotic infarclions in the younger group. The Elderly group had a significantly higher percentage of atherothrombotic infarction (OR 2.757, P 0.014). With respect to the risk factors, in case of hypertension, the elderly group had 53 patients (58.2%) and the younger group had 46 patients (46.5%). This was the only risk factor which showed a statistically significant difference (OR 0.432, P 0.014). In the elderly group, there were 19 (19.2%) major territory infarctions, and in the younger group, there were 27 (29.7%). Among the major territory infarctions (n 46), 24 (52.2%) of them underwent surgical treatment [elderly group: 6 patients (31.6%), younger group: 18 patients(66.7%)]. While there was a significant difference in the number of surgeries performed, there was no difference in the prognosis between the two groups.  Conclusion: In overall, lacunar intarction was the most common type and the percentage of male pateints was  higher in both groups (elderly group: 57.1%, younger group: 63.6%). More than half the patients had history of hypertension and the elder group had a higher incidence. The elderly group had a higher incidence of atherothrombotic than the younger group. The number of patients with major territory infarction who had undergone surgical treatment was higher in the younger group but there was no significant difference in the overall outcomes between the two groups.

Key Words:

Cerbral Infarcion · Subtypes · Risk factor · Elderly · surgery · prognosis



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