Influence of Anemia on Clinical and Radiological Presentation of Adult Patients with Acute
Brain Infarction

Abstract

Abstract:

Objective To analyze and explore the clinical and radiological features of patients with acute brain infarction and anemia. Methods We retrospectively reviewed adult stroke patients with anemia in our hospital consecutively from January 1, 2010 to June 30, 2013. Acute brain infarction should be confirmed by diffusion-weighted magnetic resonance imaging. Clinical characteristics and radiological profiles were evaluated. Results Twenty-seven patients (14 males and 13 females) were enrolled, with an average age of (67.1±11.9) years (49~84 years), and mean hemoglobin concentration of (67.5±18.5) g/L (33~107 g/L). The patients have following characteristics:13 patients (48.1%) with risk factors for stroke 1. Thirteen patients (48.1%) had consciousness disturbance. Thirteen patients (48.1%) recurred in two weeks. Sixteen patients (59.3%) presented with acute multiple brain infarction (AMBI), and 12 patients (75%) of the AMBI involving more than one circulation. Conclusion Brain infarction with anemia is associated with high AMBI rate, high recurrence rate, high consciousness disturbance and less risk factors. AMBI involving more than one circulation is common in acute brain infarction with anemia.

Key words: Acute multiple brain infarction; Anemia; Diffusion-weighted magnetic resonance
imaging

摘要：

目的分析总结急性期脑梗死合并贫血患者的临床、影像学特点。方法回顾分析成人急性期脑梗死合并贫血患者的临床资料，总结其临床特点并分析急性梗死病灶的分布特征。结果入组27例患者，男性14例，女性13例，平均年龄（67.1±11.9）岁（49～84岁），平均血红蛋白浓度（67.5±18.5）g/L（33～107 g/L）。该组患者具有如下特点：13例（48.1%）患者卒中危险因素≤1，13 例（48.1%）患者出现意识障碍。16例（59.3%）患者表现为急性多发性脑梗死（acute multiple brain infarction，AMBI），12例（75%）的AMBI累及1个以上循环。13例（48.1%）在2周内有卒中复发并加重。结论脑梗死合并贫血患者卒中危险因素少，但急性期内复发率高，出现意识障碍及AMBI患者比例较高，累及1个以上循环的AMBI多见。

关键词: 急性多发性脑梗死; 贫血; 磁共振弥散成像

WANG Jing-Ye, ZHANG Hui, ZHUO Sheng-Xia, et al.. Influence of Anemia on Clinical and Radiological Presentation of Adult Patients with Acute
Brain Infarction[J]. Chinese Journal of Stroke, 2014, 9(09): 757-761.

汪敬业，张辉，卓胜霞，等. 成人急性脑梗死合并贫血患者的临床及影像学特点分析[J]. 中国卒中杂志, 2014, 9(09): 757-761.

References

1 Oyama N, Moriwaki H, Yamada N, et al. Estimation

of stroke etiology from lesion patterns on diffusionweighted

magnetic resonance imaging in patients with

carotid artery occlusive disease[J]. Eur Neurol, 2013,

69:142-148.

2 Mustanoja S, Putaala J, Haapaniemi E, et al. Multiple

brain infarcts in young adults:clues for etiologic

diagnosis and prognostic impact[J]. Eur J Neurol,

2013, 20:216-222.

3 Lee DK, Kim JS, Kwon SU, et al. Lesion patterns and

stroke mechanism in atherosclerotic middle cerebral

artery disease:early diffusion-weighted imaging

study[J]. Stroke, 2005, 36:2583-2588.

4 Roh JK, Kang DW, Lee SH, et al. Significance of

acute multiple brain infarction on diffusion-weighted

imaging[J]. Stroke, 2000, 31:688-694.

5 Baird AE, Lovblad KO, Schlaug G, et al. Multiple

acute stroke syndrome:marker of embolic disease?[J].

Neurology, 2000, 54:674-678.

6 Saito K, Moriwaki H, Oe H, et al. Mechanisms

of bihemispheric brain infarctions in the anterior

circulation on diffusion-weighted images[J]. AJNR

Am J Neuroradiol, 2005, 26:809-814.

7 De puydt S, Sa rov M, Va nde nd r i e s C, e t a l .

Significance of acute multiple infarcts in multiple

cerebral circulations on initial diffusion weighted

imaging in stroke patients[J]. J Neurol Sci, 2014,

337:151-155.

8 Fagniez O, Tertian G, Dreyfus M, et al. Hematological

disorders related cerebral infarctions are mostly

multifocal[J]. J Neurol Sci, 2011, 304:87-92.

9 Lee JH, Kim YJ, Moon Y, et al. Acute simultaneous

multiple lacunar infarcts:a severe disease entity in

small artery disease[J]. Eur Neurol, 2012, 67:303-311.

10 Wen HM, Lam WW, Rainer T, et al. Multiple acute

cerebral infarcts on diffusion-weighted imaging and

risk of recurrent stroke[J]. Neurology, 2004, 63:1317-

1319.

11 Hong JM, Bang OY, Chung CS, et al. Frequency

and clinical significance of acute bilateral cerebellar

infarcts[J]. Cerebrovasc Dis, 2008, 26:541-548.

12 Tanne D, Molshatzki N, Merzeliak O, et al. Anemia

status, hemoglobin concentration and outcome after

acute stroke:a cohort study[J]. BMC Neurol, 2010,

10:22.

13 中华医学会神经病学分会脑血管病学组急性缺血性

脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治

指南2010[J]. 中华神经科杂志, 2010, 43:146-153.

14 Zhang C, Qin YY, Chen Q, et al. Alcohol intake

and risk of stroke:A dose-response meta-analysis of

prospective studies[J]. Int J Cardiol, 2014, 174:669-

677.

15 Dostovi Z1, Smajlovi D, Dostovi E, et al. Stroke and

disorders of consciousness[J]. Cardiovasc Psychiatry

Neurol, 2012, 2012:429108. Epub 2012 Sep 3.

16 耿介立, 林岩, 徐群, 等. 缺血性卒中患者的危险因素分

析[J]. 上海交通大学学报(医学版), 2008,4:409-413.

17 Huang WY, Chen IC, Meng L, et al. The influence

of anemia on clinical presentation and outcome

of patients with first-ever atherosclerosis-related

ischemic stroke[J]. J Clin Neurosci, 2009, 16:645-649.

18 Hao Z, Wu B, Wang D, et al. A cohort study of

patients with anemia on admission and fatality after

acute ischemic stroke[J]. J Clin Neurosci, 2013, 20:37-

42.

19 Keller t L, Mar tin E, Sykora M, et al. Cerebral

oxygen transport failure? decreasing hemoglobin

and hematocrit levels after ischemic stroke predict

poor outcome and mor t ality:STroke:RelevAnt

Impact of hemoGlobin, Hematocrit and Transfusion

(STRAIGHT)--an observational study[J]. Stroke,

2011, 42:2832-2837.

20 Keller t L, Herweh C, Sykora M, et al. Loss of

penumbra by impaired oxygen supply? decreasing

hemoglobin levels predict infarct growth after

acute ischemic st roke:St roke:Relevant Impact

of Hemoglobi n, Hematoc r it and Tr ansf usion

(STRAIGHT)-An observational study[J]. Cerebrovasc

Dis Extra, 2012, 2:99-107.

[1]	ZHANG Xiao-Dan, YOU Xiao-Fan, TIAN Yu-Jin,TIAN Fang, LUO Cheng. Effect of Anemia on the Prognosis of Acute Ischemic Stroke [J]. Chinese Journal of Stroke, 2019, 14(02): 111-115.
[2]	LIU Huan-Hu;PAN Xu-Dong. Sickle Cell Anemia and its Effects on Hemdynamics [J]. , 2008, 3(02): 128-130.