Vascular risk factors in patients with ischaemia in the infratentorial vertebrobasilar territory
Introduction. Arteriosclerosis is the commonest aetiology of vertebro-basilar ischemia (VBI). In the literature few studies mention the risk profile of cerebrovascular accidents at this site. Material and methods. In order to establish whether this profile has specific characteristics, we carried out a transversal study of 70 patients with VBI of artherothrombotic origin situated in the brain stem or cerebellum, determining the prevalence of the main risk factors (RF). The results were compared with a control group of individuals who had no cerebral vascular pathology and also with another group who had arteriosclerotic obstructive lesions of the carotid artery as an example of involvement of another vascular territory. Results. In the group of patients with VBI we found greater prevalence of hypertension, smoking, ischaemic cardiopathy, peripheral vascular disease and excessive alcohol consumption together with raised levels of arterial hypertension, haematocrit, haemoglobin and total cholesterol as compared with the control group and within a similar range to the group of patients with ischemia of the carotid territory. We underline the high prevalence of diabetes in patients with VBI (45.7%), considerably greater than that of the control group (12.5%), than those with carotid pathology (20.4%) and that described in the literature (17-25%). Conclusions. According to our results, the prevalence of RF in VBI and in carotid pathology is similar, except in the case of diabetes. This may play a more decisive role in territory such as the vertebro-basilar, where vascularization is basically by small calibre vessels
Resultados En el grupo de pacientes con IVB encontramos mayor prevalencia de hipertensión, tabaquismo, cardiopatía isquémica, enfermedad vascular periférica y consumo excesivo de alcohol, así como valores más elevados de tensión arterial, hematocrito, hemoglobina y colesterol total, con respecto al grupo control y en rangos similares al grupo de pacientes con isquemia en el territorio carotídeo. Destacamos la alta prevalencia de diabetes en el grupo de pacientes con IVB (45,7%), muy superior a la del grupo control (12,5%), al grupo con patología carotídea (20,4%) y a la referida en la literatura (17-25%).
Conclusiones Según nuestros resultados, la prevalencia de FR en la IVB y en la patología carotídea es similar, salvo en el caso de la diabetes, la cual podría desempeñar un papel más determinante en un territorio como el vertebrobasilar, donde la vascularización es fundamentalmente a expensas de vasos de pequeño calibre
