Læknablaðið : fylgirit - 01.05.2002, Blaðsíða 40

POSTERS / 3 3RD SNC & 2ND SCNN
waves of the ECG were located and time-series were constructed
from consecutive R-R intervals. After calculating the mean R-R
interval and its variance the latter was decomposed into 3 different
frequency components by means of spectral analysis: VLF (very
low frequency) < 0.05 Hz; LF between 0.05 - 0.15 representing
sympathetic activity; HF between 0.15 and 0.5 Hz representing
parasympathetic activity.
Results: Patients showed increased heart rate compared with
controls (p<0.05). The LF component of HRV was increased in
the patient group (p<0.05) but the HF component was similar in the
two groups. In the patient group there was not a significant
difference between the LF and the HF components whereas within
the control group the HF component was stronger.
Conclusion: The results show evidence of disrupted sympathetic/
parasympathetic balance following stroke. HR and the LF compo-
nent of HRV were increased in the patient indicating an increased
sympathetic tone.
P05 - Microangiopathic dementia: A case report from singapore
Auchus AP, Chen CPLH, Wilder-Smith E, Yu GXE, Wong MC
Dept. of Neurology, Singapore General Hospital, Singapore
Objective: To describe a case of subcortical ischemic vascular de-
mentia secondary to a non-CADASIL, small vessel vasculopathy.
Material and methods: A 46 year-old Chinese woman developed
subacute dementia over 1.5 years. She had no chronic medical
problems and no family history of similar illness. Examination
revealed apathy, memory loss, pseudobulbar affect and gait apraxia.
Head CT demonstrated moderate leukoaraiosis with no lacunes,
hydrocephalus or cerebral atrophy. Brain MRI showed multifocal,
confluent, white matter hyperintensities without areas of infarction.
Biochemical analyses, syphilis and HIV serologies, and screens for
collagen vascular disorders were normal. Cerebrospinal fluid was
acellular and sterile, with normal protein content. Malignant cells,
markers for neurotropic viruses, and oligoclonal bands were absent.
P100 latencies were normal on VER, and EEG showed inter-
mittent generalized slowing. Carotid and vertebral arteriography
was normal. Vascular biopsy was performed on the palm. The
biopsied material included skin and subcutaneous tissue, and was
processed for light (LM) and electron (EM) microscopy using
standard methods.
Results: LM revealed no evidence of perivascular inflammatory cell
infiltrates, neoplasia, vessel hyalinization or fibrinoid necrosis. On
EM, there was no granular osmophilic material (GOM) in smooth
muscle cells as seen in CADASIL. Instead, we found hypertrophic
and cuboidal endothelial cell changes producing luniinal narrowing
of capillaries and post-capillary venules. In addition, endothelial
cells demonstrated abnormal vacuolization and villous-like invagi-
natons of their plasma membranes.
Condusion: This middle-aged, Chinese woman developed progres-
sive dementia from severe ischemic subcortical brain injury. Al-
though large and medium-sized vessels were normal, ultrastruc-
tural studies revealed pathological changes in microvessels sug-
gestive of an endothelial cell disorder.
P06 - Stroke is different in men and in women. The Copenhagen
Stroke Study
Jorgensen HS, Mosegaard D, Houth JG
Dept. of Neurology, Gentofte Hospital, Copenhagen, Denmark
Purpose: Men and women differ in stroke incidence and possibly
also regarding the functional anatomy of the brain. We compared
risk faclor distribution, CT findings, initial stroke severity, and
outcome between sexes.
Methods: We prospectively included 1,197 unselected patients with
acute stroke from the community-based Copenhagen Stroke Study.
Data were analyzed in multiple regression models.
Results: Men were younger (70.8 vs 77.3 years, p<0.01), had more
frequently a daily alcohol use (p<0.01), a previous myocardial
infarct (p<0.01), diabetes (p=0.04), a previous stroke (p=0.04), and
were smokers (p<0.01), but had less frequent hypertension
(p=0.02). CT lesion size, side and regions were comparable between
sexes, but women had more frequent a hemorrhage (11% vs 7%,
p=0.02). Initial stroke severity was generally less severe in men
(Scandinavian Stroke Scale score on acute admission was 37 vs 32
points, p<0.01). Mortality was in the univariate analysis comparable
between sexes, but when differences in age, initial stroke severity,
and risk factor distribution was considered, mortality was increased
in men (relative risk 1.8,95% CI 1.2 to 2.6, p<0.01).
Conclusion: Men and women differ in several aspects of stroke: in
risk factor distribution, in initial stroke severity, in distribution of
stroke subtype, and in outcome. We speculate that this difference
may be explained by either differences in stroke pathology, and/or
differences in functional anatomy or plasticity of the brain between
sexes.
P07 - Quality of life after stroke in Estonia
Lembra E, Körv J, Roose M, Kaasik A-E
Department of Neurology and Neurosurgery, University of Tartu, Estonia
Objective: To study the quality of life of the patients who have
suffered from acute stroke in Estonia.
Material and methods: All consecutive acute stroke patients
admitted to the Department of Neurology, Tartu University Clinics,
were registered in 1999. Six months and 1 year after the stroke the
patients were sent a postal questionnaire including MOS SF-36.
Additionally, the patients were contacted by investigators; those
with the diagnoses of aphasia and/or dementia (<24 in MMSE)
were excluded. The results of stroke patients were compared with
age- and sex-matched controls drawn from the population registry
of Estonia.
Results: At 6 months and 1 year after stroke 59 and 48 patients,
respectively, were considered eligible for the study. The changes in
MOS SF-36 during this period were nonsignificant. Comparison of
the results of the patients and controls at 6 months revealed dif-
ferences in most items of MOS SF-36, except for the domains of
bodily pain and role limitations due to emotional health. No
differences were found between the younger (< 70) and older (> 69)
patients. At the same time the older controls were significantly
poorer in the domain of physical functioning compared with
younger controls. Differences between the younger patients and
controls were found in all domains, except for the domains of
bodily pain and role limitations due to emotional health. No
40 Læknablaðið/Fylgirit 43 2002/88