$424 Thursday, November 10, 2005 Poster Abstracts

expression was higher in the chronic ischemic lesions than in the acute lesions. Contusion: Under chronic ischenfic condition, brains may respond for neuroprotection by increasing the expression of C×43 and UCPs.

1270 Transient lsehemie Attack in Chinese

Ng, PW ~, Sha, KY ~. 1United Christian Hospital, Hong Kong SAR

Background: Transient ischemic attack (TIA) is a syadrome character- ized by sudden onset of focal neurological deficit due to a vascular lesion wlffch resolves within 24 hours. Patients suffered from TIA have a high risk of subsequent vascular events. However there is limited data in Chinese patients. Method: Tiffs is a retrospective review of all Chinese patients admitted to United Christian hospital (serving a population of 600,000) with a diagnosis of TIA in 2003 -2004. The presentation, cerebrovascular risk factors, investigation results, treatment and subsequent events were noted. Result: In 2003-200:1, 212 Chinese patients were discharged with a diagnosis of TIA. There were 115 male and 97 female. Their age ranged from 32-96 years. The commonest symptom on presentation was motor weakness (62%) followed by speech problem (19%). All except 1 patients had CT scan of the brain done. 50% of CT brain results were normal, 21% showed non specific ischemic changes whereas 20% showed infarcts in the corresponding territory. Most common risk factors were hypertension (70%), hyperlipidaemia (148%) and diabetes mellitus (28%). Carotid doppler was carried out in 69 patients with only 6 showing sigtffficant stenosis. Anti-platelet or atttithrombotic was given to 204 patients with aspirin in 89%. Vascular events occurred in 44 patients (20.7%) during a follow up of 4 to 28 months and 55% of these took place within 90 days. Conclusion: In view of the high risk of vascular outcomes, aggressive management was warranted in Clffnese patients presented as TIA.

1271 Chronic Chlamydia pneumoniae infection and stroke in Cameroon: a case-control study

Njamnshi, A t'z, Njanmshi, C 4, Ngu Blackett, K 3'2, Mbuagbaw, j3,2, Gupta, S 5. 2Central Hospital Yaounde-Neurology Service, Cameroon; :Department of lnternal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University Of Yaounde I, Cameroon; 3University Hospital Cotter, Yaounde, Cameroon; 4Cardiac Clinic, Department of Medicine, Department of Medicine, University of Cape Townm South Africa; SDepartment of Cardiology, Whipps Cross University Hospital, London, United Kingdom

Objective: To detemrine the relationslffp between chronic Chlamydia pneumoniae infection and stroke in Cameroon. Methods: Sixty-four consecutive patients, aged 26 to 80 years, presenting with stroke at two University Teaching Hospitals in Yaound6 Cameroon, were enrolled into tiffs study between March 2000 and December 2001. Patients were matched for age, sex and hypertension with 64 controls. We measured IgG (1/64) and IgA (1/16) titres against Chlamydia pneumoniae in both patients and controls using micro-immunofluorescence assay. Results: There was no significant difference between the patients and controls with respect to current smoking status (p -- 0.48), alcohol intake (p - 0.41), body mass index (p -- 0.41), waist-to-lffp ratio (p - 0.17), waist circumference (i3 - 0.06), and diabetes (13 -- 0.71). IgG antibodies were detected in 41 (164.1%) patients and 35 (54.7%) controls (odds ratio [OR] 1.51, 95% confidence intervals [CI] 0.8 to 3.1, p - 0.25). IgA antibodies were detected in 51 (79.7%) patients and 27 (42.2"/0) controls (OR 5.0, 95% CI 2.3 to 10.8, p < 0.0001). In the subgroup of confirmed ischaenffc stroke, the association with IgA antibodies became even stronger (OR 22.6, 95"/0 CI 5.0 to 102.5,

p < 0.000001), but there was no association with IgG antibodies (OR 1.:1, 95% CI 0.6 to 3.3, p - 0.43). Contusions: The current study confirms the strong statistical associa- tion between chronic Chlamydia pneumorfiae infection and stroke, for the first time in a resident indigenous central African population. These findings may have important policy implications in sub-Saharan Africa.

1272 Stroke in Sickle-cell patients in Yaounde

A.K. Njamnslfi 1, E. N. Mbong 1, P. Ongolo-Zogo 1, V. Djientcheu 1, L. Dongmo 1, D. Mbanya ~, W. Munak 1Neurology Service, Central Hospital Yaounde; Faculty of Medicine & Biomedical Sciences, University of Yaounde, Cameroon

Background/Purpose: Sickle-cell disease has been reported as the first cause of stroke in clffldren in Yaounde (Cameroon) but the prevalence of stroke in tiffs population has never been studied. We therefore carried out a cross-sectional study to determine the prevalence and some characteristics of stroke in sickle-cell disease children in Yaounde. Patients/Methods: Homozygous SS sickle cell patients attending two sickle-cell clinics over a three-month period were subjected to a questionnaire and physical examination including a complete neuro- logical examination to look for features of past or present stroke. Stroke was confirmed where possible with a brain CT scan. Results: 120 homozygous sickle-cell patients (mean age 13.49 ± 8.79 years) were included in the study. Eight cases of stroke (mean age 16.6 d_ 11.2 years) were identified, giving a stoke prevalence of 6.67%. Ischaenffc stroke was thrice as common as hemorrhagic stroke and the former more frequent in subjects less than 20 years (5.21% as against 0.00 %); the latter in patients older than 20 (8.33% as against 4.17%). The missed stroke diagnosis rate was 25.00%. None of the risk factors examined showed a significant association with stroke. Contusions: Stroke is a serious, unrecogtffzed complication of sickle- cell disease in Yaounde. There is an urgent need to implement stroke morbidity reduction measures in Cameroonian sickle cell patients and to perform larger studies to examine risk factors, within the context of a comprehensive sickle-cell disease control programme.

1273 Good corrdations between Serum Adiponeetin Levels and other Hematological markers of Cardiovascular Disease's risks in patients with past history of Stroke

Nomura, E ~, Naka, H a, Takahashi, T ~, Kohriyama, T ~ , Matsumoto, M ~. 1Department of Clinical Neuroscience and Therapeutics, Hiroshima University, Graduate School of Biomedical Sciences, Hiroshima, Japan; 2Department of Neurology, Suiseikai Kujikawa Hospital, Hiroshima, Japan

Purpose: Adiponectin, a newly found adipose tissue-specific collagen- like protein, has been noted as an important antiatherogenic protein, and its serum levels have been reported to be lower in patients with atherogenic diseases, such as diabetes or dyslipidemia. Our purpose of tiffs study was to explore the correlations between adiponectin and other hematological markers of cardiovascular disease's risks in patients with a past history of stroke. Subjects and Methods: One hundred and three patients (mean age 69.0 years, 53.4 % male) with a past history of stroke (179 ischemic and 24 hemorrhagic) were enrolled. We determined the levels of insulin, HbAlc, total cholesterol (TC), high density lipoprotein cholesterol (HDL), triglycerides (TG), apolipoprotein A1 (apo-Al), apolipopro- rein B (apo-B), adiponectin, high sensitive CRP (Its CRP), and plasminogen activator inhibitor type l (PAI-1). Correlations between them were calculated with Spearman rank correlation coeffident. Results: Adiponectin levels showed sigtffficant inverse correlations with insulin (p - 0.0002), H b A l c (p - 0.0266), TG (p - 0.0036), apo-B (p -- 0.0009), hsCRP (p _ 0.0024), and PAL1 (p _ 0.0157) levels,

Poster Abstracts Thursday, November 10, 2005 $425

whereas positively correlated with HDL (13 = 0.0002) and a13o-Al (13 = 0.0039) levels. There was no significant correlation between adiponectin and TC (p 0.6630) levels. Conclusion: In patients with past history of stroke, serum adiponectin levels correlated well with other markers of cardiovascular disease's risk, indicating necessity of investigating whether or not adiponectin levels could be a reliable marker of stroke recurrence.

I274 Sleel~disordered breathing in patients with recent Isctlaemic Stroke

Noradina T l, Harnidon B ~, Roslan H 1, Raymond A ~ . 1Department of Medicine, Universiri Kebangsaan Malaysia

Intxoduction: Several studies reported a higher frequency of sleep disordered breathing (SDB) among ischaemic stroke patients. Many showed prevalence between 43% and 72%, taking the apnoea hypo13noea index (AHI) of _>10. Hypertension and coronary heart disease are known risk factors of stroke, which are also consequences of SDB that can contribute to stroke mortality and morbidity. Objectives: The objectives were to detemrine the frequency of SDB in patients with recent ischaemic stroke admitted to H U K M and the relationship between SDB and known risk factors of ischaemic stroke. Method: This was a cross-sectional prospective study involving 28 consequtive acute ischaemic stroke patients admitted to H U K M over three months. Sleep studies were done within 1 to 4 weeks after stroke onset using ResMed Autoset portable 11 plus system. Results: The prevalence of SDB in ischaemic stroke depending on the AHI cut off was: 92.8% for AHI > 5, 78.5% for AHI > 10, 44.5% for AHI _> 15 and 37.7?,'; for AHI _> 20. We discovered that diabetes mellitus (DM) and smoking history were important factors predicting significant SDB (AHI _> 15) in recent ischaemic stroke. Conclusion:There was a high prevalence of SDB in recent ischaemic stroke patients in H U K M comparable to other studies. DM and smoking history were strong predictors of the occurrence of SDB after an ischaernic stroke.

1275 Hyperhomoeysteinemia as a Risk Factor for Ischemie Stroke

Noroozian, M 1, Sina, A 1, Masoud Rad, W, Shaigany, S 1. ZTehran University Of Medica! Sciences (TUMS)

Background: The aim of this study is to investigate the correlation between plasma Homocysteine (Hey) level and ischemic stroke by better controlling risk factors for the ischemic stroke and factors affecting the levels of plasma Hey. Method: We conducted a case-control study with 31 cases who had never had a Transient Ischemic Attack (TIA), all within one week of their first-ever ischernic stroke. Both the patients and control subjects were paired for age, sex, cardiac disease, hypertension and smoking status. Their total fasting plasma Hey level was determined, using High-Performance Liquid Chromatography (HPLC) method. Results: Mean plasma Hey level was significantly higher in cases than controls (mean, 20.79 -c 11.938 versus 14.45 ± 8.028 gmol/L; P < 0.017). After using the multivariate logistic, regression model, we found a significant correlation between plasma Hey level and stroke (OR 1.149 with 95% CI of 1.032-1.280 for each 1/~mol/L increment). Conclusion: This finding indicates a correlation between increasing plasma Hey level and ischemic stroke; although further researches is needed to prove the cause and effect relationship between the two.

1276 Stroke in South West Nigeria - a ten year review

Ogun, y1, Ojini, F z, Ogungbo, B 3, Kola13o , K1, Danesi, M z. ~Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria," 2Lagos University Teaching Hospital, Lagos, Nigeria," 3Division Of NeuroSurgery, New Castle Upon Tyne, United Kingdom

Background and Purpose: Stroke is a significant economic, social and medical problem worldwide. This retrospective follow-up study aimed to review the pattern, types and case fatality of stroke in Nigeria. Methods: Records of all stroke patients adnfitted into Ogun State University Teaching Hospital (OSUTH), sagamu, from December 1993 to November 2003 were reviewed. Patients were classified into haemorrhage or infarct using the WHO criteria. Information was obtained as to the time of death in those who died and case fatality at 24 hours, 7 days, 30 days and 6 months recorded. Autopsy records were also reviewed. Results: A total of 708 stroke patients were reviewed and this constituted 2.4% of all emergency admissions. On clinical grounds, 49% of the patients had cerebral infarction (CI), 45% intracerebral haemorrhage (ICH) while 6% had subarachnoid haemorrhage (SAH). Stroke constituted 1.8% of all deaths at the emergency unit and the case-fatality was 9% at 24 hours, 28% at 7 days, 40% at 30 days and 46% at 6 months. Conclusion: Stroke constitutes a significant cause of mortality and the need for prompt institution of intensive treatment is em13hasised. A changing pattern with an increasing frequency of haemorrhagic stroke in our population is suspected. However, as this was a retrospective study based on clinical exanfination in a highly selected stroke population, neuro-imaging confirmation would be needed for any future prospective hospital or population-based studies.

1277 Pure agraphia tot Romaji, tile thixd JapaneSe writing system utilizing alphabet and phonological rules

Ogura, K 1, Suzuki, K 1, Mori, E 1. 1Tohoku University Graduate School of Medicine, Sendai, Japan

We report a Japanese man who developed pure agraphia selectively affecting Romaji. Romaji is an alphabetic writing system for Japanese based on phonological rules, the ttfird Japanese writing system after Kana and Kanji, which is in general used exclusively for typewriting. The patient was a 51-year-old right-handed Japanese clerical worker with 12 years of education, who was referred to us because o f difficulty in typing. MRIs revealed an infarct affecting a lower part of the precentral gyms and pars opercularis o f the inferior frontal gyrus. Hand-writing was defective as well. Neurological examination was unremarkable including spoken language and praxia. The agraphia had following features: (1) many errors in Romaji, occasional errors in Kana (syllabograms), and no error in Kanji (morphograms); (12) the same nature of errors in oral spelling, hand-writing, and typing of Romaji; (13) errors consisting mainly of substitution with another letters with proper consonant/vowel structure in a syllable. These findings suggest that the basic defect of the Romaji agraphia in this patient is a selective functional disruption within the 13honeme-to - grapheme conversion system, and that the neural mechanism proces- sing consonants is distinct for that for vowels in Japanese.

1278 Combined Occlusive Anterior Cerebral Artery in patients with Acute Middle Cerebral Axtery Occlusion

Hyung Geun Oh l, Kwang Ho Lee 1, Gyung Moon Kim 1, Chin-Sang C.hung 1, Tai Hwan Park a. 1Department of NeurMogy, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; 2Department of Neurology, Chungang University Medical Center, Seoul, Korea

Background: Le13tomeningeal collateral flow (LCF) from anterior cerebral artery (ACA) and/or posterior cerebral artery (PCA) can be a potential source of blood supply in the territory distal to the occluded middle cerebral artery (MCA). Methods: We reviewed clinical and attgiographic findings in 29 patients with acute MCA occlusion. Digital subtraction angiography was