Poster Abstracts Thursday, November 10, 2005 $413

branch of the superior cerebellar artery (MSCA) has not yet been fully characterized, although single cases have been reported. Methods: We studied the cliuical features of 14 patients with all isolated cerebellar infarction in the territory of the MSCA diagnosed by brain MRI. Results: Isolated MSCA territory cerebellar infarction represented 30?,'; (114/47) of the all SCA infarction in our stroke registry from January 2000 to February 2005. All but 1 had acute infarction in the rostral vermis on brain MRI. The most common and striking clinical finding at onset was severe gait ataxia with sudden fall (n -- 9) or severe veering (in - 2). Eleven (85%) of 13 patients with vermal involvement could not walk without assistance. Cerebellar dysarthria was found in 8 patients, all o f whom had infarction in the rostral paravermal region of the anterior lobe. Eight patients had hemispheric dysfunction with a mfilateral limb ataxia (mild compared to the truncal ataxia). Ten patients showed no occlusion in the vertebrobasilar system on brain MRA. Eight had a cardiac source of emboli. All patients improved spontaneously. Conclusions: Infarction in the territory of the MSCA typically produces a distinct clinical syndrome characterized by the severe truncal ataxia, cerebellar dysarthria, and mild ipsilateral extremity ataxia. It usually results from cardiac emboli.

1227 Prolonged Hypotension after Carotid Artery Stenting

Lee BC ~, Yu KH a, Kim JH ~, Kim KH a . 1Department of Neurology, Hallym University College of Medicine, Seou~ Korea

Background: Acute hemodynanfic instability after carotid artery stenting (CAS) is relatively well recognized. We experienced several cases with prolonged hypotension after CAS and proposed a possible predictor of post-stenting prolonged hypotension. Methods: Blood pressure (BP) was measured every 1 hour from pre- dilatation period to post-stenting 1 day in 7 cases with CAS performed with self expandable stent. Prolonged hypotension was defined as greater than 30 mmHg decrease in systolic arterial BP compared with baseline lasting at least 1 hour or requiring vasopressor agents. Results: Four patients had prolonged hypotension of 7 patients. In all patients with prolonged hypotension, CAS was performed in left side. The patients with prolonged hypotension were older (median of age 67 vs. 58) and inserted with longer stent than patients without prolonged hypotension. Tire vascular risk factors (hypertension, use of anti-hypertensive agent before procedure, diabetes mellitus, and smoking), degree of pre and post-stent dilatation, and ultrasono- graphic characteristics of carotid plaques were not different. Conclusion: Our case series support that old age and laterality of procedure (left side of carotid artery) might be related with development of prolonged hypotension after CAS. These findings should be clarified by large prospective clinical study.

1228 Associated Vascular risk factor for extra- and intracranial Athero- sclerosis in Korean Patients

Soo-Joo Lee, MD 1, Boram Lee, MD 1, Jung-Eun Kim, MD 1, Gun-Sei Oh, MD ~, Tae-Hyung Kim, MD ~, Yong-Seok Lee, MD a. 1Department of Neurology, EuD'i University Hospital, Ezdfi University School of Medicine, Daejeon, South Korea; 2Department of Neurology, Seoul Municipal Borarnae Hospital, College of Medicine, Seoul National University, Seoul, Korea

Background: Besides race-ethnicity, the role of other risk factors that can be related to the distribution of cerebral atherosclerosis has been controversial. Objective: We determined if there were vascular risk factors related to the extra- and intracranJal atherosclerosis in Korean stroke patients. Methods: We studied 856 consecutive patients with ischemJc stroke adnfitted to our two hospitals over a 5-year period. We excluded

patients who had potential cardiogenic source of embolism. We determined the location and severity of atherosclerotic lesions on MR angiography (MRA). The presence of atherosclerotic lesion in intracranial cerebral arteries and extracrauial carotid artery was defined as 50% or more narrowing of lunfinal diameter or occlusion on MRA. The information about potential vascular risk factors such as age, sex, arterial hypertension, diabetes mellitus, hyperlipidemia, cigarette smoking, and alcohol consumption, was obtained from medical records. Results: Three hundred fifty-five patients (41.5%) had intracranial atherosclerotic lesion on MRA. Sixty-one patients (7.1%) had steno- occlusive extracranial carotid artery disease, and 78 (9.1%) had combined extracranial carotid and intracranial atherosclerotic lesions. Multivariate logistic regression analyses showed that hyperli- pidemia were significantly associated with the extracrauial carotid atherosclerosis (OR, 4.12; 95% CI, 1.21 9.11, p < 0.01), but that diabetes mellitus was only associated with intracrauial atherosclerosis (OR, 3.26; 95°'; CI, 1.45-6.52, p < 0.01). Contusions: Our data suggest that the risk factors for extra- and intracranial artery lesion are different. Diabetes mellitus may be associated with the development of intracrarfial atherosclerosis, which disease is predominant in Korean patients.

1229 Territorial distribution of Infarctions in patients with Poslerior Cerebral Artery Occlusion

Lee, JY~, Nam, HS 1, Heo, JH 1. 1Department of Neurology, Yonsei University College of Medicine, Seoul, Korea

Background: The posterior cerebral artery (PCA) branches several perforators during its course to the cortex. Although there many patients presented with PCA occlusion, little is known regarding the territorial distribution of infarctions in association with PCA occlusion. Methods: Among 2202 ischemic stroke patients, who were registered in Yonsei Stroke Registry and underwent both angiograptfic studies and brain MRI, those with PCA occlusion were identified. Occlusion sites, territorial distribution of infarctions, and etiologic mechanisms were investigated in them. Results: PCA occlusion was found in 60 patients. (12.77,'8; 46 men and 14 women; aged 28 to 82 years; mean 64.2). Of these, 3 patients were excluded from analyses due to unavailable image scans. The occlusion was clinically relevant in 47 patients (MRA 20, conventional angiography 27). The site of occlusion was at P1 in 19 and at P2 or the distal sequent in 28 patients. In P1 occlusion, cortical artery territories were the most frequent sites of infarctions (68.4%), which was followed by thalamogeniculate arteries (152.6%). In P2 or distal artery occlusion, cortical artery infarctions were also most common (82.1%), followed by tire splenial artery (67.9%). No patient showed infarctions involving tire entire vascular territories, while 42.1% of P1 occlusion and 21.4% of P2 occlusion had an infarction involving only one branch arterial territory. Large-artery atherosclerosis was the most frequent subtype in both groups (P1 52.6?,'8, P2 57.17,'8). Contusions: Occlusion of the PCA caused infarctions involving only a part of the vascular territories, which suggests tire presence of local collateral flows.

1230 Length of Middle Cerebral Artery susceptibility sign on T2*- weighted Gradient Echo MRI correlates with initial Stroke severity

Kwang Ho Lee ~, Gyung Moon Kim ~, Chin-Sang Chung ~, Tat Hwan Park 2, Oh-Sang Kwon ~. 1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea," 2Department of Neurology, Chungang University Medical Center, Seoul, Korea