뇌졸중 후 골다공증 환자의 골밀도 및 임상 양상

The Bone Mineral Density and Clinical Manifestations of Osteoporosis in the Patients with Cerebral Stroke

Background: Stroke patients have high prevalence of osteoporosis and fracture. Low bone mineral density (BMD) and fracture may contribute to further functional loss. The purposes of this study were to investigate the clinical manifestations of osteoporosis in the patients with stroke and define the relationship between functional parameters and BMD. Methods: The subjects were 33 female stroke patients with cerebral infarction (n=24) and cerebral hemorrhage (n=9). Group I patients were 17 cases below three months of the duration from onset to the time to do BMD; Group II were 16 cases above three months. Clinical parameters were BMD in the affected limbs of stroke patients, vertebral fracture and femur fracture on radiographs, and the relationship between functional parameters (gait, motor power, spasticity, neurologic deficit, activities of daily living) and BMD. Results: Of the 33 stroke patients with stroke, 9 (27%) had vertebral fractures and 3 (9%) had femur fracture. There were not significant differences in spine and femur BMD between the two groups (P＞0.05). Modified Ashworth score and National Institute of Health Stroke Score (NIHSS) were significantly correlated to BMD of group II (P＜0.05). Gait, motor power, and ADL were unrelated to the BMD of two groups (P＞0.05). Conclusion: Results showed a high prevalence of vertebral fracture in the patients with stroke and correlation between BMD and clinical parameters. Therefore early screening and active management of osteoporosis in the patients with stroke is crucial to prevent possible complications.