Clinical analysis of related factors for progression and prognosis in branch atheromatous disease (BAD)

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  • Ｂｒａｎｃｈ　Ａｔｈｅｒｏｍａｔｏｕｓ　Ｄｉｓｅａｓｅ（ＢＡＤ）の進行と予後に関連する因子の臨床的検討

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Background and Purpose: Branch atheromatous disease (BAD)-related factors have not yet been fully elucidated. We sought to identify the factors associated with the progression and prognosis of BAD and to compare the factors found in patients with supratentorial BAD (s-BAD) and infratentorial BAD (i-BAD). Materials and Methods: We enrolled 110 patients (74 patients with s-BAD and 36 with i-BAD) who were diagnosed with BAD by diffusion-weighted imaging (DWI) of the head carried out within 48 hours after onset. Patients who showed a drop in their NIHSS score of 2 or more within 48 hours after admission were defined as progressive cases, and those with a modified Rankin Scale (mRS) score of more than 2 at discharge were defined as cases with a poor prognosis. Results: Seventeen patients with s-BAD (23.0%) and 15 with i-BAD (41.7%) were identified as progressive cases; and 32 with s-BAD (43.2%) and 13 with i-BAD (36.1%) were identified as cases with a poor prognosis. Multivariate analysis employing progression and poor prognosis as objective variables revealed the factors that were significantly associated with progression to be age in the s-BAD group and diabetes mellitus in the i-BAD group. The factors that were significantly associated with a poor prognosis were age and NIHSS score at admission in the s-BAD group, and age in the i-BAD group. Conclusion: Our findings suggest that some differences exist between s-BAD and i-BAD, which may arise from differences in the vascular system; and further studies are needed to provide a full clarification.<br>

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