Cerebral Amyloid Angiopathy in East and West

Cerebral amyloid angiopathy, a vasculopathy characterised by the deposition of amyloid fibrils in the arteries and arterioles in the cerebral cortex and meninges, has been reported to be associated with intracerebral haemorrhage and cognitive impairment in the elderly. Advances in neuroimaging and validation of the clinical diagnostic criteria aid in making a correct clinical diagnosis. Associations with Alzheimer's disease, asymptomatic microbleeds and white matter changes on neuroimaging have an influence on the clinical treatment for patients with probable cerebral amyloid angiopathy. Reviewing the reports from Asian countries, we found that patients with cerebral amyloid angiopathy have a strong age-related prevalence and a consistent association with dementia, but a weaker correlation with intracerebral haemorrhage, most likely due to a higher incidence of hypertensive intracerebral haemorrhage. Involvement of the occipital lobe arteries by CAA is common in all races and ethnicities, while frontal lobe arteries may be more frequently involved in the East compared to the West. The clinical impact of cerebral amyloid angiopathy on intracerebral haemorrhage and cognitive impairment could be increasingly obvious in Asian countries with ageing populations, especially with improving control of hypertension, the leading cause of intracerebral haemorrhage

高血壓患者中風知識及其相關影響因素之探討

[[abstract]]背景與目的：高血壓患者認識及瞭解中風相關知識有助於降低中風的發生和確保中風發作時的即時反應。儘管高血壓患者是中風的高危險群，但有關於高血壓患者中風知識的數據資料仍缺乏。本研究目的在探討高血壓患者的中風知識及其相關影響因素。方法：採橫斷式調查性研究，於南桃園某區域醫院心臟內科門診收案，共有310位之高血壓患者進行調查。研究工具包括基本資料問卷、中風知識量表-中文版，以SPSS 17.0版進行建檔與統計分析。結果：本研究中75.5%的高血壓患者的中風知識低於平均水準，中風知識答錯率題項前二名為「哪個年齡層最容易中風」、「如果有疑似中風的症狀，應該什麼時候打電話叫救護車？」；中風知識自我認同知識缺口題項前二名為「台灣成年人中風發生率，每千人約有多少人？」、「短暫性腦缺血發作的警訊徵象大多於多久內消失？」。高血壓患者「年齡」與中風知識呈弱的負相關（r= -0.268，p ＜ 0.001），而「教育程度」（F = 51.04，p ＜ 0.001）、「家人是否罹患中風」（t = 2.65，p ＜0.001）、「是否接受中風相關衛教」（t = 2.74，p ＜ 0.001）與中風知識有顯著差異。結論：由本研究結果顯示高血壓患者尚缺乏足夠中風知識，建議可透過公共或社會媒體幫助高血壓患者認識中風知識、安排患者於門診候診時給予衛教並透過提供教育光碟和相關知識之衛教單張提升患者的中風知識