PATTERN OF CEREBRAL ATHEROSCLEROSIS IN HONG-KONG CHINESE - SEVERITY IN INTRACRANIAL AND EXTRACRANIAL VESSELS

Background and Purpose: The clinical pattern of stroke and the angiogr aphic distribution of cerebral atherosclerosis in Chinese are differen t from those in Caucasians. Pathological data from autopsy studies are lacking. Methods: The intracranial and extracranial arteries supplyin g the brains of 114 consecutive Chinese patients undergoing autopsy in a regional general hospital were examined by computer-assisted morpho metric analysis under a microscope as well as by macroscopic grading f or atherosclerotic narrowing. The severity was correlated with various atherosclerosis-related factors. Results: Atherosclerosis of the intr acranial cerebral vessels was more severe than that of the extracrania l vessels. The distal branches of the intracranial vessels were also c ommonly involved. Hypertension and diabetes mellitus were identified a s factors associated only with intracranial atherosclerosis (p<0.001), whereas ischemic heart disease was associated with atherosclerosis in both the intracranial (p<0.001) and extracranial (p=0.012) vessels. S moking was associated with narrowing of the extracranial vessels only (p=0.0054). Conclusions: Compared with figures from Caucasian and Japa nese populations, the extent of intracranial atherosclerosis is much m ore severe in Hong Kong Chinese, whereas atherosclerotic narrowing of the extracranial carotid artery is less severe in Hong Kong Chinese th an in Caucasians.