The relationship between alcohol consumption and the risk of ischemic stroke has been widely studied, whereas the effect of alcohol use on stroke features is not well established. This study compared the clinical and stroke features of ischemic stroke in two groups of patients with ischemic stroke: those with a history of alcohol misuse and those with a history of more social drinking. DSM-IV criteria were used to diagnose alcohol use disorder (dependency or abuse) in 275 of 486 consecutive patients aged 55–85 years, 3–4 months after ischemic stroke. Magnetic resonance imaging of the head was performed 3 months after stroke. Alcohol use disorder was diagnosed in 37/275 (13.5%) of ischemic stroke patients. These patients had more frequently (70.3 vs. 34.5%; OR 4.5; 95% CI 2.2–9.1; p < 0.000) an infarct affecting the putamen compared with patients who indulged in more social drinking. Another predisposed area was the superior anterior cerebral artery area. The stroke due to large- artery atherosclerosis was more common in patients with alcohol use disorder. The misuse of alcohol seemed to be associated with cerebral infarct localization in the putamen and superior anterior cerebral artery area. Prospective studies are needed to verify our preliminary finding.

Keywords:
Alcohol drinking, Stroke, Cerebrovascular disorders, Putamen
1.
Palomäki H, Kaste M: Regular light-to-moderate intake of alcohol and the risk of ischemic stroke: Is there a beneficial effect? Stroke 1993;24:1828–1832.
2.
Hillbom M: Alcohol consumption and stroke: Benefits and risks. Alcohol Clin Exp Res 1998;22(suppl):352–358.
3.
Berger K, Ajani U, Kase C, Gaziano M, Buring J, Glynn R, Hennekens C: Light-to-moderate alcohol consumption and the risk of stroke among US male physicians. N Engl J Med 1999;341:1557–1564.
4.
Sacco RL, Elkind M, Boden-Albala B, Lin IF, Kargman DE, Hauser WA, Shea S, Paik MC: The protective effect of moderate alcohol consumption on ischemic stroke. JAMA 1999;281:53–60.
5.
Pohjasvaara T, Leppävuori A, Siira I, Vataja R, Kaste M, Erkinjuntti T: Frequency and clinical determinants of post-stroke depression. Stroke 1998;29:2311–2317.
6.
Vataja R, Pohjasvaara T, Leppävuori A, Mäntylä R, Aronen HJ, Salonen O, Kaste M, Erkinjuntti T: Magnetic resonance imaging correlates of depression after ischemic stroke. Arch Gen Psychiatry 2001;58:925–931.
7.
Leppävuori A, Pohjasvaara T, Vataja R, Kaste M, Erkinjuntti T: Insomnia in ischemic stroke patients. Cerebrovasc Dis 2002;14:90–97.
8.
Leppävuori A, Pohjasvaara T, Vataja R, Kaste M, Erkinjuntti T: Generalized anxiety disorder three to four months after ischemic stroke. Cerebrovasc Dis 2003;16:257–264.
9.
Pohjasvaara T, Erkinjuntti T, Vataja R, Kaste M: Dementia three months after stroke: Baseline frequency and effect of different definitions for dementia in the Helsinki Aging Memory Study (the SAM) stroke cohort. Stroke 1997;28:785–792.
10.
Pohjasvaara T, Erkinjuntti T, Vataja R, Kaste M: Comparison of stroke features and disability in daily life in patients with ischemic stroke aged 55–70 and 71–85 years. Stroke 1997;28:729–735.
11.
Pohjasvaara T, Mäntylä R, Salonen O, Aronen HJ, Ylikoski R, Hietanen M, Kaste M, Erkinjuntti T: Complex interactions of ischemic brain infarcts, white matter lesions and atrophy relate to poststroke dementia. Arch Neurol 2000;57:1295–1300.
12.
Adams HP, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, Marsh RR, for the TOAST Investigators: Classification of subtype of acute ischemic stroke: Definitions for use in a multicenter clinical trial. Stroke 1993;24:35–41.
13.
World Health Organization: SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Geneva, WHO, 1992.
14.
Wing JK, Cooper JE, Sartorius N: Measurement and Classification of Psychiatric Symptoms: Instruction Manual for the PSE and CATEGO System. London, Cambridge University Press, 1974.
15.
Wing JK, Babor T, Brugha T, Burke J, Cooper JE, Giel R, Jablenski A, Regier D, Sartorius N: SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry 1990;47:589–593.
16.
American Psychiatric Association (APA): Diagnostic and Statistical Manual of Mental Disorders, ed 4 (DSM-IV). Washington, APA, 1994.
17.
BMDP New System for Windows. Los Angeles, BMDP, 1994.
18.
SPSS 10.0 for Windows. Chicago, SPSS Inc, 1999.
19.
Scandinavian Stroke Study Group: Multicenter trial of hemodilution in ischemic stroke: Background and study protocol. Stroke 1985;16:885–890.
20.
Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state’: A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
21.
Anderson C, Rubinstein D, Filley CM, Stears JC: MR enhancing brain lesions on methanol intoxication. J Comput Assist Tomogr 1997;21:834–836.
22.
Lotfi J, Meyers JS: Cerebral hemodynamic and metabolic effects of chronic alcoholism. Cerebrovasc Brain Metab Rev 1989;1:2–25.
23.
Onada A, Maruki Y, Matsuzaki M, Narabayasi Y, Sawada M, Iwasaki A, Enokida M, Kanaya M, Akiyama H, Yamauchi T: Abstinence from drink ameliorated cerebral blood flow and vasoreactivity in patients with chronic alcoholism. Keio J Med 2000;suppl 1:A107–A108.
24.
Sun H, Patel KP, Mayhan WG: Impairment of neuronal nitric oxide synthase-dependent dilation of cerebral arterioles during chronic alcohol consumption. Alcohol Clin Exp Res 2002;26:663–670.
25.
Sacco R: Newer risk factors for stroke. Neurology 2001;57(suppl 2):31–34.
26.
Darstein M, Albrecht C, Lopez-Francos L, Knorle R, Holter SM, Sanagel R, Feuerstein T: Release and accumulation of neurotransmitters in the rat brain: Acute effects of long-term voluntary ethanol intake. Alcohol Clin Exp Res 1998;22:704–709.
27.
Crews FT, Steck JC, Chandler LJ, Yu CJ, Day A: Ethanol, stroke, brain damage and excitotoxicity. Pharmacol Biochem Behav 1998;59:981–991.
28.
Tsai G, Coyle JT: The role of glutamatergic neurotransmission in the pathophysiology of alcoholism. Annu Rev Med 1998;49:173–184.
29.
Lipton SA, Rosenberg PA: Excitatory amino acids as a final common pathway for neurologic disorders. N Engl J Med 1994;330:613–622.
© 2003 S. Karger AG, Basel
2003
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.