$402 Thursday, November 10, 2005 Poster Abstracts

Conclusion: Although the p reconditioning with 3-NPA is clearly shown in the setting of permanent ischemia, the preconditioning with this mitochondrial toxin demonstrated a rather narrow safety therapeutic window (critical threshold). Coordinated Care Across Healthcare Systems, a Disease Management Concept - the Singapore Model for Stroke Care.

1182 Regional difference of Cerebral Arterial Stenosis in Acute Stroke patients: a Hospital-Based survey in China

Huang, y1, He, M 1, Liu, X 2, Li, X 2, Lu, C 3, Cui, L 2, Guo, y2, Huang, R 4, Chen, Q1 Liu, X 5. 1Department of Neurology, Pelting University First Hospital, Beijing, China; ~Department of Neurology, Pelting Union Medical College Hospital Beijing, China; 3Department of Neurology, Fudan University Huashan Hospital Shanghai, China; 4Department of Neurology, Zhongshan University First Hospital, Guangzhou, China; ~Department of Neurology, Sina-Yapan Friendship Hospital China

Background: China is a huge country. The living custom and economic level have a great gap between regions, which may affect the incidence of cerebral arterial stenosis. Tiffs study is purposed to evaluate the cerebral arterial involvement from various area. Method: 1283 cases with ischemic stroke within 7 days after onset were collected from June of 2003 to June of 2004 in 30 hospitals, which distribute around the countrywide and belong to county, province and national hospitals. We divided them into 3 economic levels depending on the local GPT. The patients underwent one of morphologic exanrination, i.e. carotid Duplex, MRA, CTA or DSA and one of hemodynanffc exanffnation, i.e. TCD and carotid duplex to confirm the arterial lesions. Results: 1063 cases (83.5%) successfully fulfilled the vascular examinations. We found cerebral arterial stenosis in 53.4% of the patients. Among them, 57% located in intracranial, 13% in extracranial, and 27°,5 in both. There is no significantly difference in the patients from small to large hospitals. The patients from poorer area had lower incidence of stenosis (OR 0.856, 95°'; CI 0.751-0.976, p -- 0.0:10). After excluding the influence of age, hypertension and diabetics, Logistic analysis still shows that region is an independent risk factor of arterial stenosis (OR 0.849, 95% CI 0.743 0.969, p - 0.015), but there is no significant superiority of the arterial distribution of lesions from various regions. Conclusion: We found lower incidence of cerebral stenosis in the hospitals from lower economic development. It is an independent from the known risk factors.

I183 Risk factors and outcome o[ Dysphagia alter an Acute Ischaemic Stroke

Nabil, I t, HamJdon, B 1, Rizal, AM ~, Raymond, AA 1. 1Hospital Universiti Kebangsaan Ivlalaysia, R~ala Lumpur, Malaysia

Background: Dysphagia occurs frequently after stroke and is a major hazard as it puts patients at risk of mahmtrition and aspiration pneumonia. We aimed to identify the risk factors for and outcome of dysphagia over the first 3 months after acute ischaemic stroke. Methods: Patients with acute first-ever were prospectively studied. The assessment of dysphagia was made using standardized clinical methods. All patients were followed up for 3 months. Results: 134 patients were recruited in the study. 55 p atients (141 °,5) had dysphagia at presentation, and 29 (21.9°,5) patients were dysphagic at 1 month. 12 patients continued to have swallowing dysfunction at 3 months. Age of more than 75 years independently predicted the occurrence of dyphagia at presentation [OR 3.31 (195°'; CI 1.31 - 8.35)], at 1 month [OR 4.95 (195% CI 1.75 - 14.01)], and 3 months [OR 6.76 (95% CI 1.67 27.42)] after an acute stroke. Involvement of the middle cerebral artery territory was more frequently associated with (54.5 vs. 29.1%; p < 0.003), and significantly predicted dysphagia occurence at

presentation [OR 3.02 (95?,'; CI 1.15 - 7.95)]. Contralateral silent cerebral infarct was an independent predictor of dysphagia at pre- sentation [OR 2.60 (95% CI 1.03 6.55)], one [OR 6.39 (95% CI 2.24 18.26)], and 3 months [OR 15.05 (95% CI 3.68 61.5)]. Dysphagiawas also found to be an independent predictor of mortality at presentation [OR 6.09 (95% CI 1.79 20.72)] and at 1 month [OR 12.10 (95% CI 3.10 - 47.26)]. Conclusions: Advance age and contralateral silent cerebral infarct was independently associated with the presence of dysphagia. Stroke mortality can be independently predicted by the presence o f dysphagia.

1184 Asso clarion of vascular parldnsoulsm with impaired neuronal integrity in the gtriatum

ltlara M l, Tomimoto H l, lstffzu K ~, Nakaji K l, Hashikawa K t, Fukuyama H t. ~Kyoto University, Kyoto, Yapan

Background: [1~C] flmnazenil (FMZ), a ligand that selectively binds to the central berLzodiazepine receptor in the neuronal membrane, is useful for evaluating neuronal viability in a PET scan. Using this ligand, we sought to identify the underlying differences between patients with leukoaraiosis who manifested vascular parkinsonism and those who did not. Method: Twelve patients with extensive leukoaraiosis (Sctmffdt scale score of 3), as determined by MRI, were divided into groups based on their neurological signs i.e., patients with parkinsonism (group P; 1 man and 4 women; 73.7+/-~1.6 yr) and those without parkinsonism (group NP; 1 man and 4 women; 77.0+/ 3.2 yr). Dopanrinergic therapy had been ineffective for all patients in group P. Neuronal integrity was evaluated by calculating the distribution volume of FMZ (FMZ-Va). Regional cerebral blood flow (rCBF) was also examined using the 150 gas steady-state method. These values were then compared between the 2 groups of patients. Results: MRI showed that the mean+~SD number of lacunae (5 mm < diameter < 15 mm) in the striatum was slightly larger in group P (group P, 1.14+/ 0.90; group NP, 0.60+~0.55; p - 0.26). ROI-based PET analysis demonstrated that FMZ-Va and rCBF were both significantly reduced in the striatum in group P than in group NP (FMZ-Vd, 17.2%, p < 0.01; rCBF, 25.:1%, p < 0.05). Consistently, SPM analysis showed that FMZ-Vd was significantly reduced in the bilateral striatum ( P ~ o = < 0.0005). Condusioas: Cerebral ischemia in patients with leukoaraiosis may result in impaired neuronal integrity in the striatum, thereby contributing to development of vascular parkinsonism.

1185 ClinicM ctlaraeterisfies of in-hospital Stroke: how should we prevent, anti possibility of the intervenfional therapy

Iwashita, T l, Unno, yl,~. 1Department of Internal Medicine, Kawaldta General Hospital, Tokyo, Japan; 2Department of Medicine, Kitasato University Hospital, Kanagawa, Japan

Baekgrou,td: Patients with in-hospital stroke can be rapidly assessed to start an appropriate treatment including interventional therapy as soon as possible. The purpose of tiffs study is to investigate clinical characteristics of in-hospital stroke. Method: A Series of seventeen patients who had a stroke while already in hospital for reasons other than stroke (9 men and 8 women, mean age 74.2) were studied. We evaluated clinical characteristics, brain CT and MRI retrospectively. Results: Reasons for admission included 2 for myocardial infarction, 4 for congestive heart failure, 1 for diabetic gangrene, 4 for fracture, and 6 for gastrointestinal disorders. All in-hospital strokes were ischemic, including 6 thrombosis, 8 embolism and 2 unknown types. One or more risk factors of strokes (hypertension, diabetes mellitus, hyperlipidemJa, and hyperuricenffa) existed in 14 of 17 patients. Six of 17 patients had atrial fibrillation and 3 of 17 patients had a history of