22. European Stroke Conference 300 Etiology of stroke and risk factors Current Smoking and Silent Brain infarct are associated with Stroke Occurrence in the pa-tients with Right to Left Shunt. H.K. Park1, J.Y. Choi2, J.H. Rha3 Department of Neurology, Inha University Hospital, Incheon, SOUTH KOREA1, Department of Neurology, Inha University Hospital, Incheon, SOUTH KOREA2, Department of Neurology, Inha University Hospital,, Incheon, SOUTH KOREA3 Background and Purpose: Right-to-left shunt (RLS) is known to be associated with cryptogenic ce-rebral infarction and migraine. However, it has not been elucidated, which factors affect the stroke occurrence in the patients with RLS. Here, we sought to determine the prevalence of risk factors in two groups and to find the radiological predictors for stroke. Methods: We performed a retrospective review of the medical records and brain MR image of patients with RLS, aged between 40 and 80, who visited our hospital for treatment of migraine or cryptogenic infarction from January, 2008 to June, 2012. Patients with potential risk factors for cardioembolism like aortic atheroma(>4mm) and atrial fibrillation were excluded. RLS was defined as >/=11 micro-embolic signals(MESs) on the agitated saline test, using Transcranial Doppler sonography. We de-fined white matter hyperintensities(WMHs), as the Fazekas score>/=2, and assessed the prevalence of each risk factors and radiological findings in stroke and migraine group. Results: A total of 489 patients were included in this study(stroke; 55.7±11.0, N=257 vs migraine; 56.0±10.5, N=232). On univariate analysis, the patients with stroke had the higher ratio of men, hy-pertension, diabetes, dyslipidemia and current smoking than the migrainers. On multivariate bina-ry regression test, the odds ratio of current smoking was highest(OR=10.08, 95% CI; 4.38~23.17). The stroke group had the high frequency of silent brain infarct(28.3% vs 5.2 %, P<0.01) and WMHs(13.1% vs 6.9%), compared to those with migraine. There was no difference in age, intra/ex-tracranial stenosis, microembolic signal number or microbleeds between two groups. Conclusions: Some cardiovascular risk factors, especially silent brain infarct and smoking history were associated with stroke occurrence in the patients with RLS. These results suggest that the eval-uation of risk factors and brain images could be helpful for the prediction of stoke in the patients 444 © 2013 S. Karger AG, Basel Scientific Programme with RLS. 301 Etiology of stroke and risk factors Clinical Characteristics of Ischemic Stroke with Previous Exposure to Agent Orange S.W. Ha1, J.Y. Hwang2 Department of neurology, Veterans Heath Sevice Medical Center, Seoul, SOUTH KOREA1, Department of neurology, Veterans Heath Sevice Medical Center, Seoul, SOUTH KOREA2 Background and Objectives Agent Orange is the code name for one of the herbicides and defoliants used in the Vietnam War for herbicidal warfare program. TCDD (2,3,7,8-tetrachlorodibenzo- p-dioxin), a material of agent orange, was reported as a deadly poison in spite of its presence at extremely small doses. A correla-tion between exposure to TCDD and cerebral infarction is not yet known. Thus, we intended to ex-amine the correlation between preceding TCDD exposure and the clinical characteristics of cerebral infarction. Methods We studied patients with acute ischemic stroke within 7days of onset in Veterans hospital. Among them, 119 consecutive patients with previous exposure to agent orange were evaluated. For con-trolled group, 119 patients were assigned in a 1:1 ratio (age, sex matched) among 756 stroke patients from 4 other general hospitals. Results Diabetes was the most common risk factor in exposure group (57.1%) compared with non exposure group (46.2%) (P=0.001). Among stroke etiology, small vessel occlusion was the most common subtype(43%) in exposure group followed by large-artery atherosclerosis (30.3%) but in non expo-sure group, the large artery atherosclesosis was the most common subtype(43.7%) and small vessel occlusion was followed(24.4%). There were no significant differences in proportion of each cardio-embolic Conclusion We determined that there are differences in stroke risk factors and subtypes of stroke etiology be-tween exposure group and other group. These indicate that the TCDD might come into causes of stroke and further study is needed for the TCDD with stroke etiology.
Karger_ESC London_2013
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