Migraine as a Risk Factor for White Matter Lesions, Silent Infarctions, and Ischemic Stroke: The Potential Mechanisms and Therapeutic Implications

2005 ◽  
Vol 2 (3) ◽  
pp. 53-57 ◽  
Author(s):  
H. C. Diener ◽  
T. Kurth
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
White Matter ◽  
White Matter Lesions ◽  
Therapeutic Implications

scholarly journals Risk Stratification Tool for Ischemic Stroke: A Risk Assessment Model Based on Traditional Risk Factors Combined With White Matter Lesions and Retinal Vascular Caliber

2021 ◽  
Vol 12 ◽  
Author(s):  
Lu Zhao ◽  
Bin Jiang ◽  
Hongyang Li ◽  
Xiufen Yang ◽  
Xiaoyue Cheng ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Risk Factor ◽  
Ischemic Stroke ◽  
White Matter ◽  
White Matter Lesions ◽  
Traditional Risk Factor ◽  
Assessment Model ◽  
Risk Assessment Model ◽  
Retinal Vascular Caliber ◽  
Traditional Risk Factors

Objective: This study aims to establish a risk assessment model based on traditional risk factors combined with the Fazekas classification of white matter lesions and retinal vascular caliber for screening the patients at high risk of ischemic stroke.Methods: This study included 296 patients (128 cases of ischemic stroke and 168 cases in the normal control group). The basic data of the patients were collected. Color fundus photography was performed after pupil dilation, and the retinal vascular caliber was measured using semiautomated vascular measurement software (IVAN Software, Sydney, Australia). The severity of white matter lesions (WML) on cranial nuclear magnetic fluid-attenuated inversion recovery images were assessed using the Fazekas scale. Moreover, logistic regression analysis was used to establish different risk assessment models for ischemic stroke. The effects of models were evaluated through the receiver operating characteristic (ROC) curve and the Delong test compared area under the curve.Results: The sensitivity and specificity of models 1 (the traditional risk factor model), 2 (the retinal vascular caliber model), 3 (the WML model), and 4 (the combined the traditional risk factor, WML and central retinal artery equivalent (CRAE) model) were 71 and 55%, 48 and 71%, 49 and 67%, and 68 and 68.5% with areas under the curve of 0.658, 0.586, 0.601, and 0.708, respectively. The area under the receiver operating characteristic curve in models 1, 2, 3, and 4 showed statistically significant differences. Moreover, no statistical significance exists in the pairwise comparison of other models.Conclusion: The risk assessment model of ischemic stroke combined with Fazekas grade of WML and CRAE is superior to the traditional risk factor and the single-index model. This model is helpful for risk stratification of high-risk stroke patients.

Migraine as a Risk Factor for White Matter Lesions, Silent Infarctions, and Ischemic Stroke: The Evidence for a Link

2005 ◽  
Vol 2 (3) ◽  
pp. 62-70 ◽  
Author(s):  
Mark C. Kruit ◽  
Lenore J. Launer ◽  
Mark A. van Buchem ◽  
Gisela M. Terwindt ◽  
Michel D. Ferrari
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
White Matter ◽  
White Matter Lesions

scholarly journals Prevalence of Cerebral Microbleeds in Thai Patients with Ischemic Stroke

2017 ◽  
Vol 08 (02) ◽  
pp. 216-220 ◽  
Author(s):  
Artit Potigumjon ◽  
Arvemas Watcharakorn ◽  
Pornpatr A. Dharmasaroja
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Magnetic Resonance ◽  
White Matter Lesions ◽  
Cerebral Microbleeds ◽  
National Institutes Of Health ◽  
Asian Origin ◽  
Chinese Study ◽  
Japanese Studies ◽  
Magnetic Resonance Imaging Mri

ABSTRACT Background: With the widespread use of magnetic resonance imaging (MRI), cerebral microbleeds (CMBs) are commonly detected. Ethnicity seems to play a role in the prevalence of CMB, with higher prevalence in participants from Asian origin. The purpose of the study is to look for the prevalence of CMBs and associated factors in Thai patients with ischemic stroke. Methods: Patients with acute ischemic stroke who had MRI and magnetic resonance angiography during January–August 2014 were included in the study. T2*-weighted gradient-recalled echo was used to define CMBs. Baseline characteristics, stroke subtypes, and severity of white matter lesions were compared between patients with and without CMBs. Results: Two hundred patients were included in the study. Mean age of the patients was 61-year-old. Mean National Institutes of Health Stroke Scale was 8. The prevalence of CMBs was 20% (39/200 patients). Hypertension (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.07–8.68, P = 0.037), and moderate-to-severe white matter lesions (Fazekas 2–3, OR 7.61, 95% CI 3.06–18.95, P < 0.001) were related to the presence of CMBs. Conclusions: CMBs were found in 20% of patients with ischemic stroke, which was lower than those reported from Japanese studies but comparable to a Chinese study. CMBs were associated with hypertension and severity of the white matter lesions.

scholarly journals Association of Ambulatory Blood Pressure and Heart Rate With Advanced White Matter Lesions in Ischemic Stroke Patients

2013 ◽  
Vol 27 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Hyuk Sung Kwon ◽  
Young-Hyo Lim ◽  
Hyun Young Kim ◽  
Hee-Tae Kim ◽  
Hyung-Min Kwon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Ischemic Stroke ◽  
White Matter ◽  
Ambulatory Blood Pressure ◽  
White Matter Lesions ◽  
Stroke Patients

High-sensitivity cardiac troponin T and severity of cerebral white matter lesions in patients with acute ischemic stroke

2018 ◽  
Vol 266 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Regina von Rennenberg ◽  
Bob Siegerink ◽  
Ramanan Ganeshan ◽  
Kersten Villringer ◽  
Wolfram Doehner ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Acute Ischemic Stroke ◽  
Cardiac Troponin ◽  
Troponin T ◽  
White Matter Lesions ◽  
High Sensitivity ◽  
Cerebral White Matter ◽  
Cardiac Troponin T ◽  
Cerebral White Matter Lesions

scholarly journals Leukoaraiosis Is a Chronic Atherosclerotic Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Einor Ben-Assayag ◽  
Milija Mijajlovic ◽  
Shani Shenhar-Tsarfaty ◽  
Irena Bova ◽  
Ludmila Shopin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
White Matter ◽  
Multivariate Logistic Regression Analysis ◽  
White Matter Lesions ◽  
Intima Media Thickness ◽  
Atherosclerotic Disease ◽  
Stroke Patients ◽  
Vascular Events ◽  
Tight Association ◽  
Ischemic Attack

Background and Purpose.White matter changes (WMCs), or leukoaraiosis (LA), are associated with increased age, hypertension, diabetes mellitus, and history of stroke. Although several lines of evidence suggest a role of atherosclerosis in atherothrombotic vascular events, their involvement in LA remains to be determined. Our study examines this association in ischemic stroke patients.Methods.One hundred and seventy consecutive ischemic stroke or transient ischemic attack (TIA) patients were included. All patients underwent brain computed tomography (CT) with assessment of the extension and severity of WMCs, carotid arteries duplex scan with measurements of intima-media thickness (IMT) and plaques.Results.Seventy-two patients (42.4%) were found to have white matter lesions, of whom 28.8% had advanced LA. Mean IMT was significantly higher in patients with LA and with advanced LA (P=0.002,P=0.003, resp.). In addition, LA and LA severity were associated with existence of carotid plaque (P=0.007,P=0.004, resp.). In multivariate logistic regression analysis, including all vascular risk factors, LA was found to be associated with age and IMT.Conclusion.This study reinforces the tight association between LA and carotid atherosclerosis in ischemic stroke patients. We conclude that a chronic atherosclerotic disease underlies the pathophysiology of leukoaraiosis and its progression.

NOTCH3 cysteine-altering variant is an important risk factor for stroke in the Taiwanese population

Neurology ◽  
2019 ◽  
Vol 94 (1) ◽  
pp. e87-e96 ◽  
Author(s):  
Yi-Chung Lee ◽  
Chih-Ping Chung ◽  
Ming-Hong Chang ◽  
Shuu-Jiun Wang ◽  
Yi-Chu Liao
Keyword(s):  
Risk Factor ◽  
Ischemic Stroke ◽  
Clinical Manifestations ◽  
White Matter Lesions ◽  
Reference Population ◽  
Important Risk Factor ◽  
Vessel Occlusion ◽  
Asian Populations ◽  
Modifying Factors ◽  
Increased Risk

ObjectiveTo test the hypothesis that the prevalence and clinical effect of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) have been underestimated in Asian populations.MethodsThe Taiwan Biobank, containing 1,517 Taiwanese genome sequences, was queried for pathogenic NOTCH3 cysteine-altering mutations. NOTCH3 mutations identified in the reference population were genotyped in 7,038 stroke- and dementia-free individuals and 800 patients with ischemic stroke. NOTCH3 genotyping, clinical manifestations, and the severity of white matter lesions on MRI were compared between the 2 groups.ResultsThree cysteine-altering NOTCH3 variants (p.R544C, p.C853Y, and p.C884Y) were identified from the Taiwan Biobank. We confirmed that the NOTCH3 p.R544C mutation was present in a significant number of individuals in Taiwan, including 60 of the 7,038 healthy controls (0.9%), 17 of the 800 patients with ischemic stroke (2.1%), and 16 of the 245 patients with small vessel occlusion (SVO) stroke (6.5%). The other 2 cysteine-altering mutations were rarely detected. After adjusting for vascular risk factors, harboring the p.R544C variant resulted in a 3.40-fold increased risk for overall stroke and an 11.05-fold increased risk for SVO stroke (p = 0.0001 and 3.9 × 10−10, respectively). Three symptom-free individuals carrying the p.R544C mutation had extensive leukoencephalopathy typical of CADASIL at age 59, 66, and 67, suggesting that p.R544C-related CADASIL could remain subclinical at advanced age.ConclusionThe NOTCH3 p.R544C variant is an important risk factor for SVO stroke in Taiwan. Phenotypic variation among individuals carrying a NOTCH3 mutation indicates the existence of disease-modifying factors in CADASIL.

scholarly journals Connecting Cerebral White Matter Lesions and Hypertensive Target Organ Damage

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Cristina Sierra ◽  
Alfons López-Soto ◽  
Antonio Coca
Keyword(s):  
Risk Factor ◽  
White Matter ◽  
Brain Damage ◽  
White Matter Lesions ◽  
Organ Damage ◽  
Left Ventricular ◽  
Cerebral White Matter ◽  
Chronic Hypertension ◽  
Cerebral White Matter Lesions ◽  
The Brain

Chronic hypertension leads to concomitant remodeling of the cardiac and vascular systems and various organs, especially the brain, kidney, and retina. The brain is an early target of organ damage due to high blood pressure, which is the major modifiable risk factor for stroke and small vessel disease. Stroke is the second leading cause of death and the number one cause of disability worldwide and over 80% of strokes occur in the elderly. Preclinical hypertensive lesions in most target organs are clearly identified: left ventricular hypertrophy for the heart, microalbuminuria for the kidney, fundus abnormalities for the eye, and intima-media thickness and pulse wave velocity for the vessels. However, early hypertensive brain damage is not fully studied due to difficulties in access and the expense of techniques. After age, hypertension is the most-important risk factor for cerebral white matter lesions, which are an important prognostic factor for stroke, cognitive impairment, dementia, and death. Studies have shown an association between white matter lesions and a number of extracranial systems affected by high BP and also suggest that correct antihypertensive treatment could slow white matter lesions progression. There is strong evidence that cerebral white matter lesions in hypertensive patients should be considered a silent early marker of brain damage.

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