title: The brainstem is at high risk for recurrent noncardioembolic cerebral infarction in association with diabetes mellitus: a hospital-based study.
abstract: The goals of the study were to investigate the importance of brainstem infarction (BSI) in recurrent noncardioembolic ischemic stroke and to examine the relevant clinical background. Data were retrospectively reviewed for 655 consecutive patients with acute noncardioembolic infarction who were admitted to our hospital from January 2004 to August 2010. The patients were divided into first-stroke (n = 592) and recurrent-stroke (n = 63) groups. Acute infarcted lesions were explored on MRI, and clinical background factors including age, sex, smoking, atrial fibrillation, coronary heart disease, hypertension, hyperlipidemia and diabetes mellitus (DM) were assessed. The frequency of BSI in the recurrent-stroke group was significantly higher than that in first-stroke patients (30.2 vs. 14.9%, p = 0.0033). No other clinical background factors differed between the two groups. Only the frequency of DM differed significantly among four subgroups formed based on stroke recurrence and BSI (p < 0.0001): DM was present in 63.2% of recurrent-stroke patients with BSI, 54.5% of first-stroke patients with BSI, 27.4% of first-stroke patients without BSI, and 20.5% of recurrent-stroke patients without BSI. We conclude that the brainstem is at high risk for recurrent cerebral infarction in patients with DM.
authors.affiliation: Department of Neurology, Showa University Fujigaoka Hospital, Yokohama, Japan. h_ichikawa0527@yahoo.co.jp
authors.forename: Hiroo
authors.initials: H
authors.lastname: Ichikawa
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Ayako
authors.initials: A
authors.lastname: Kuriki
authors.forename: Hidetomo
authors.initials: H
authors.lastname: Murakami
authors.forename: Masanori
authors.initials: M
authors.lastname: Mukai
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Kawamura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020526:Brain Stem Infarctions / Q000150:complications*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors