Cerebral lesions on magnetic resonance imaging, heart disease, and vascular risk factors in subjects without stroke. A population-based study.

A 51-year-old woman was seen for evaluation of transverse myelitis. Pertinent medical history included hypertension, hyperlipidemia, and 50 pack-years of cigarette smoking. Two months earlier, she was shopping and suddenly had excruciating pain in her upper back. Two hours later, severe weakness of both hands developed abruptly. Over the next 8 hours, severe paraparesis and urinary retention developed, with inability to lift legs against gravity, and she reported a T1 sensory level. Review of the outside magnetic resonance imaging noted key imaging findings, including initially normal magnetic resonance imaging within the first 12 hours of symptom presentation, and subsequent magnetic resonance imaging on day 3 showing anterior pencil-like hyperintensity on sagittal view and anterior U- or V-shaped pattern on axial view (termed U/V pattern), without associated gadolinium enhancement. Diffusion-weighted imaging was not obtained. Given the rapid, severe deficits with pain, spinal cord infarction was considered most likely, and the magnetic resonance imaging findings were typical. Magnetic resonance angiography of the neck with T1-fat-saturated views was obtained and did not show dissection. Laboratory evaluation showed a low-density lipoprotein value of 124 mg/dL and hemoglobin A1c of 6.2%. The patient was diagnosed with probable spontaneous spinal cord infarction on the basis of diagnostic criteria. The patient was counselled on smoking cessation, started on an aspirin and statin regimen, and followed up by a primary care provider for management of vascular risk factors. Residual neuropathic pain was treated with high doses of gabapentin. Importantly, unnecessary additional immunotherapy was avoided by establishing the correct diagnosis. Spontaneous spinal cord infarctions are an underrecognized cause of acute myelopathy. Spinal cord infarctions generally occur in older persons, with most cases associated with typical vascular risk factors, arterial dissection, and fibrocartilaginous embolism; historically, cases were often secondary to syphilis.

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White matter lesions on magnetic resonance imaging and their relationship with vascular risk factors in memory clinic attenders

International Journal of Geriatric Psychiatry ◽

10.1002/gps.1283 ◽

2005 ◽

Vol 20 (3) ◽

pp. 274-279 ◽

Cited By ~ 43

Author(s):

R. Lazarus ◽

R. Prettyman ◽

G. Cherryman

Keyword(s):

Magnetic Resonance Imaging ◽

Risk Factors ◽

White Matter ◽

Magnetic Resonance ◽

White Matter Lesions ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Resonance Imaging ◽

Memory Clinic

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Vascular risk factors, apolipoprotein E, and hippocampal decline on magnetic resonance imaging over a 10-year follow-up

Alzheimer s & Dementia ◽

10.1016/j.jalz.2011.07.005 ◽

2012 ◽

Vol 8 (5) ◽

pp. 417-425 ◽

Cited By ~ 16

Author(s):

Tom den Heijer ◽

Fedde van der Lijn ◽

Arfan Ikram ◽

Peter J. Koudstaal ◽

Aad van der Lugt ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Risk Factors ◽

Magnetic Resonance ◽

Apolipoprotein E ◽

Vascular Risk Factors ◽

Vascular Risk ◽

Resonance Imaging

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Prevalence of stroke in Argentina: A door-to-door population-based study (EstEPA)

International Journal of Stroke ◽

10.1177/1747493020932769 ◽

2020 ◽

pp. 174749302093276 ◽

Cited By ~ 2

Author(s):

SF Ameriso ◽

MM Gomez-Schneider ◽

MA Hawkes ◽

VA Pujol-Lereis ◽

DE Dossi ◽

...

Keyword(s):

Risk Factors ◽

Latin American ◽

Neurological Status ◽

Population Based ◽

Vascular Risk Factors ◽

Stroke Survivors ◽

Vascular Risk ◽

Population Based Study ◽

Stroke Prevalence ◽

Obstructive Sleep

Background Stroke burden is highest and is still rising in low- and middle-income countries. Epidemiologic stroke data are lacking in many of these countries. Stroke prevalence in Argentina has been unexplored for almost three decades. Aim This population-based study aims to determine prevalence of stroke in a representative sample of the Argentinean population. Methods We performed a door-to-door survey of randomly selected households in a city of 18,650 inhabitants. A structured questionnaire screening for potential stroke cases was used. All subjects screened positive were then evaluated by stroke neurologists for final adjudication. Data about stroke subtypes, neurological status, vascular risk factors, medications, and diagnostic tests were also collected. Results Among 2156 surveys, 294 were screened positive for a possible stroke. After neurological evaluation, there were 41 confirmed cases. The adjusted stroke prevalence was 1,974/100,000 inhabitants older than 40 years, and it was higher in men than in women (26.3‰ vs 13.2‰, p<0.01). Prevalence of ischemic stroke, intracranial hemorrhage, and transient ischemic attack were 15.8‰, 2.93‰, and 2.93‰, respectively. The most prevalent vascular risk factors in stroke survivors were hypertension, obstructive sleep apnea, and dyslipidemia. Conclusion Approximately 2 in every 100 subjects older than 40 years in this population are stroke survivors. Stroke prevalence in Argentina has remained stable over the last 30 years; it is higher than in most Latin American countries and similar to western populations.

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P2-302: VASCULAR RISK FACTORS, APOE GENE ABNORMALITIES IN WHITE-MATTER MICROSTRUCTURE, AND COGNITIVE DECLINE IN OLD AGE: A POPULATION-BASED STUDY

Alzheimer s & Dementia ◽

10.1016/j.jalz.2014.05.981 ◽

2014 ◽

Vol 10 ◽

pp. P588-P588

Author(s):

Chengxuan Qiu ◽

Rui Wang ◽

Laura Fratiglioni ◽

Erika Jonsson Laukka ◽

Martin Lövden ◽

...

Keyword(s):

Risk Factors ◽

White Matter ◽

Cognitive Decline ◽

Old Age ◽

Population Based ◽

Vascular Risk Factors ◽

Apoe Gene ◽

Vascular Risk ◽

Population Based Study ◽

White Matter Microstructure

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Vascular risk factors, atherosclerosis, cerebral white matter lesions and cerebral perfusion in a population-based study

European Journal of Nuclear Medicine ◽

10.1007/bf00834530 ◽

1996 ◽

Vol 23 (6) ◽

pp. 675-682 ◽

Cited By ~ 26

Author(s):

J. J. Claus ◽

M. M. B. Breteler ◽

D. Hasan ◽

E. P. Krenning ◽

M. L. Bots ◽

...

Keyword(s):

Risk Factors ◽

White Matter ◽

Cerebral Perfusion ◽

White Matter Lesions ◽

Population Based ◽

Vascular Risk Factors ◽

Cerebral White Matter ◽

Vascular Risk ◽

Population Based Study ◽

Cerebral White Matter Lesions

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The association of lumbar intervertebral disc degeneration on magnetic resonance imaging with body mass index in overweight and obese adults: A population-based study

Arthritis & Rheumatism ◽

10.1002/art.33462 ◽

2012 ◽

Vol 64 (5) ◽

pp. 1488-1496 ◽

Cited By ~ 125

Author(s):

Dino Samartzis ◽

Jaro Karppinen ◽

Danny Chan ◽

Keith D. K. Luk ◽

Kenneth M. C. Cheung

Keyword(s):

Magnetic Resonance Imaging ◽

Body Mass Index ◽

Magnetic Resonance ◽

Intervertebral Disc ◽

Intervertebral Disc Degeneration ◽

Population Based ◽

Resonance Imaging ◽

Obese Adults ◽

Lumbar Intervertebral Disc ◽

Population Based Study

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Clinical Relevance of Cortical Cerebral Microinfarcts on 1.5T Magnetic Resonance Imaging in the Late-Adult Population

Stroke ◽

10.1161/strokeaha.120.032085 ◽

2021 ◽

Author(s):

Saima Hilal ◽

Arwin Doolabi ◽

Henri Vrooman ◽

M. Kamran Ikram ◽

M. Arfan Ikram ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Risk Factors ◽

Magnetic Resonance ◽

Cognitive Decline ◽

Clinical Relevance ◽

Color Naming ◽

Population Based ◽

Resonance Imaging ◽

Increased Risk

Background and Purpose: Cortical cerebral microinfarcts (CMIs) have been linked with dementia and impaired cognition in cross-sectional studies. However, the clinical relevance of CMIs in a large population-based setting is lacking. We examine the association of cortical CMIs detected on 1.5T magnetic resonance imaging with cardiovascular risk factors, cerebrovascular disease, and brain tissue volumes. We further explore the association between cortical CMIs with cognitive decline and risk of stroke, dementia, and mortality in the general population. Methods: Two thousand one hundred fifty-six participants (age: 75.7±5.9 years, women: 55.6%) with clinical history and baseline magnetic resonance imaging (January 2009–December 2013) were included from the Rotterdam Study. Cortical CMIs were graded based on a previously validated method. Markers of cerebrovascular disease and brain tissue volumes were assessed on magnetic resonance imaging. Cognition was assessed using a detailed neuropsychological test at baseline and at 5 years of follow-up. Data on incident stroke, dementia, and mortality were included until January 2016. Results: Two hundred twenty-seven individuals (10.5%) had ≥1 cortical CMIs. The major risk factors of cortical CMIs were male sex, current smoking, history of heart disease, and stroke. Furthermore, presence of cortical CMIs was associated with infarcts and smaller brain volume. Persons with cortical CMIs showed cognitive decline in Stroop tests (color-naming and interference subtasks; β for color-naming, 0.18 [95% CI, 0.04–0.33], P interaction ≤0.001 and β for interference subtask, 1.74, [95% CI, 0.66–2.82], P interaction ≤0.001). During a mean follow-up of 5.2 years, 73 (4.3%) individuals developed incident stroke, 95 (5.1%) incident dementia, and 399 (19.2%) died. People with cortical CMIs were at an increased risk of stroke (hazard ratio, 1.18 [95% CI, 1.09–1.28]) and mortality (hazard ratio, 1.09 [95% CI, 1.00–1.19]). Conclusions: Cortical CMIs are highly prevalent in a population-based setting and are associated with cardiovascular disease, cognitive decline, and increased risk of stroke and mortality. Future investigations will have to show whether cortical CMIs are a useful biomarker to intervene upon to reduce the burden of stroke.

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