青年缺血性卒中.ppt

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1、IschemicStrokeinYoungAdult2001/08/13IschemicStrokeinYoungadultDefinition：16-45y/oDistribution：3-4%ofallstrokeEtiology,clinicalmanifestation,andprognosisaredifferentfromelderlyItisimportanttofindtheetiologicfactorandtreatthemadequatelyforpreventingtherecurrenceOrvHetil2001Mar25

2、;142(12):607-10EpidermiologyNorthernSwedenMonica,13thirdlevelandlocalhospital,age18-44y/o,fromJan.1991-May1996,totally88casesAnnualincidence：11.3/10000013.6mvs8.9wCasefatalityrate：5.7%(within28days)4.8inNeuroNeurochirpol2000Nov-Dec;Increasedwithage：especiallyafter35y/oDramatic

3、increasedafter45inotherreportKristensen:Stroke,Volume28(9).September1997.1702-1709EpidemiologyTable1.AverageAnnualAge-andSex-SpecificIncidenceRatesofFirstIschemicStrokeinYoungAdultsinNorthernSweden,1991to1994From:Kristensen:Stroke,Volume28(9).September1997.1702-1709Epidemiolog

4、yTable1.AgesofYoungMenandWomenWithIschemicStrokeArchNeurol.1995;52:491-495EtiologyAtherosclerosisisthemaincauseofstrokeinelderly,whileemboligenouscardiopathyistheoneofthemaincauseofyoungadultAnnaliItalianidiMedicinaInterna.11(1):33-8,1996Jan-MarCardiacembolismwasthemostcommon

5、causeofstrokeinp’tyoungerthan40Stroke.30(11):2320-5,1999Nov.20018350Atherosclerosiswas38.2%andcardioembolismwas18.1%ActaNeurologicaScandinavica.101(1):19-24,Jan2000.EtiologyAtherosclerosis33.3%,Prothromboticstate15.5%,Cardiogenic9.5%OrvHetil2001Mar25;142(12):607-10Atheroscl

6、erosis29.8%,Cardioembolism19.5%,Hematologic5.8%ArchNeurol.1995;52:491-495SocardioembolismandatherosclerosisaretowmajorcauseofstrokeinyoungadultsCausearediverseEtiologyEtiologyEtiologyAtherosclerosis:a.Largearteryb.SmallarteryEmbolism:a.Cardiogenicb.Non-cardiogenicNon-Atherosc

7、lerosisartriopathy:a.Inflammatoryb.Non-inflammatoryHemologicaldisorder:a.Viscosityb.CoagulopathyOthers:EtiologyEmbolism:a.Cardiogenic:1.Valvular:RH,prosthetic,endocarditis,MVP2.Arrhythmia:Af,sicksinussyndrome3.AMI/LVaneurysm:4.LVmyxoma:5.Cardiomyopathy:EtiologyEmbolism:b.Non-c

8、ardiogenic:1.PulmonaryAVM:Osler-Weber-Rendusyndrome2.ASD/VSDo