Abstract WP116: Patterns of Vascular Calcification in Young Patients With Intracranial Stenosis

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Tamara Strohm ◽  
Irene Katzan ◽  
Ken Uchino
Keyword(s):  
Risk Factors ◽  
Vascular Calcification ◽  
Young Patients ◽  
Vascular Risk Factors ◽  
Intracranial Stenosis ◽  
Intracranial Calcification ◽  
Vascular Risk ◽  
Atherosclerotic Stenosis ◽  
Significant Difference ◽  
Determine Mechanism

Introduction: Intravascular calcification is thought to be a marker of atherosclerosis in patients with stenosis and vascular risk factors. Little is known about the utility of quantifying intracranial calcification to help determine mechanism of stenosis. The objective of our study was to compare presence and patterns of intracranial calcification in patients with intracranial stenosis due to atherosclerosis and other etiologies. Methods: Retrospective cohort study of 89 patients < 50 years with diagnosis of intracranial stenosis who had undergone CT angiogram from 2008-2013; 44 had presumed atherosclerosis as etiology ( > 3 vascular risk factors with no other identified cause). CTAs were reviewed for presence and location of intracranial calcification. Results: Of patients with atherosclerotic stenosis, 28 (64%) had intravascular calcification compared to 16 (36%) of those with stenosis of other etiologies (P=0.0039). There was no significant difference in pattern or location of stenosis between groups. One-third had calcification outside the region of stenosis in both groups. Distal internal carotid artery and distal vertebral artery were the most common sites of intracranial calcification (Table). Conclusion: Intracranial calcification is more commonly seen in patients < 50 years old with stenosis secondary to atherosclerosis, but the pattern and location was similar between groups. More research is needed to determine the utility of using the presence of vascular calcification to help determine mechanism of intracranial stenosis in the young.

Abstract TP222: Frequency of Intracranial Arterial Imaging and its Yield in Consecutive Patients with Non-lacunar Cryptogenic Ischemic Stroke: ESUS Global Registry

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Kanjana S Perera ◽  
Balakumar Swaminathan ◽  
Jackie Bosch ◽  
Robert G Hart ◽  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Latin American ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Population ◽  
Atherosclerotic Stenosis ◽  
Index Stroke ◽  
Global Registry ◽  
Arterial Imaging

Background: Atherosclerotic stenosis of large IC arteries is an important cause of stroke. The prevalence of ICS in stroke population differs by ethnicity.We report the frequency of ICS among a global sample of patients with non-lacunar cryptogenic ischemic stroke (NLCIS) who did not have another identifiable cause for stroke i.e. cardioembolic, extracranial LAD, or other specific causes. Hypothesis: We hypothesized that the prevalence rates of ICS will differ according to global regions. Methods: Consecutive patients with recent ischemic stroke were retrospectively surveyed at 19 stroke centers in 19 countries to identify the frequency of IC imaging and its yield. Countries were grouped by World Bank regions. ICS was considered to be significant if there was >50% stenosis in the arteries proximal to the index stroke evidenced by MRA, CTA or TCD. Results: We identified a total of 2145 consecutive ischemic stroke patients among which 475 had NLCIS. IC arterial imaging was carried-out,on average, in 87% of patients. Of these 414 patients, 15% had stenosis proximal to the area of brain ischemia. The frequency of ICS among NLCIS patients was highest in East Asia (27%) and lowest in Pacific (4%). Patients with ICS in Latin America were significantly younger when compared to other 4 regions. Conclusion: IC arterial imaging is carried out in majority of stroke centers in patients with NLCIS, among whom the fraction of IS associated with ICS is substantial throughout the world, averaging about 15%. MRA / CTA had a higher yield than TCD. On average these patients have traditional vascular risk factors except for Latin American patients who are significantly younger with no vascular risk factors.

Abstract W P121: Patterns Of Vessel Involvement In Patients With Intracranial Atherosclerosis Across Ages

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Tamara Strohm ◽  
Russell Cerejo ◽  
Jason Mathew ◽  
Irene Katzan ◽  
Ken Uchino
Keyword(s):  
Risk Factors ◽  
Older Patients ◽  
Age Groups ◽  
Vascular Risk Factors ◽  
Posterior Circulation ◽  
Intracranial Stenosis ◽  
Intracranial Atherosclerosis ◽  
Vascular Risk ◽  
Basilar Arteries ◽  
Vessel Involvement

Introduction: Intracranial atherosclerosis has been well studied in the aging population, much less is known about atherosclerotic stenosis in the young. Clinicians seek to control traditional vascular risk factors in this population, but differences in patterns of stenosis may call for varied treatment approaches. This study sought to compare age to the distribution of vessel involvement in patients with moderate-severe intracranial stenosis. Methods: This is a retrospective cohort study of patients with intracranial stenosis seen in the stroke clinic of a tertiary center from 2008-2013. Inclusion criteria were moderate-severe intracranial stenosis clinically felt to be due to atherosclerosis with ≥3 traditional vascular risk factors. Patients with other mechanisms of intracranial stenosis were excluded. Stenosis location and severity were based on cerebral angiography, CTA, or MRA. Patients were divided into young (< 50 yr), middle-age (51-64 yr), or older (≥ 65 yr). All 69 patients ≤50 yr were included; a random sample of 69 patients > 50 were selected for this analysis. Results: There were similar rates of vascular risk factors except HTN, which was less common in the young group (81.2% young, 100% middle, 96.8% older, p=0.0006). The location of stenoses varied by age category. Older patients had more posterior circulation involvement compared to the younger groups (p = 0.046), with more frequent involvement of vertebral and basilar arteries (p = 0.012) (Table). The occurrence of stenosis in the distal ICA and MCA vessels were similar among age groups. The frequency of ACA stenosis was highest in the young category (p = 0.026). Conclusion: There are differences in anatomic locations of presumed intracranial atherosclerosis across age groups with older patients (> 65 yrs) having a higher rate of posterior circulation disease. This suggests potential differences in pathophysiological mechanisms. These findings warrant further investigation.

scholarly journals Study of the positivity of spontaneous and directed diagnosis of leukoaraiosis in the elderly by cranial computerized tomography, and its correlation with cognitive defi cit and cardiovascular risk factors

2007 ◽  
Vol 65 (4b) ◽  
pp. 1134-1138
Author(s):  
Mauricio de Miranda Ventura ◽  
Antonio Carlos de Paiva Melo ◽  
Henrique Carrete Jr ◽  
Ricardo Vieira Botelho
Keyword(s):  
Risk Factors ◽  
Cognitive Performance ◽  
Computerized Tomography ◽  
Positive Association ◽  
The Elderly ◽  
Vascular Risk Factors ◽  
Cognitive Tests ◽  
Vascular Risk ◽  
Significant Difference ◽  
Cranial Computerized Tomography

OBJECTIVE: To evaluate the prevalence of leukoaraiosis (LA) and its correlation with vascular risk factors and the cognitive performance of elderly patients. METHOD: 78 patients were randomly selected and submitted to clinic-laboratorial evaluation for vascular risk factors. Two cognitive tests were performed. All patients were submitted to cranial computerized tomography (CT), which was analyzed in two situations: the spontaneous and the directed way. RESULTS: There was no statistically significant difference between the prevalence of spontaneous and the directed diagnoses of LA (20.5 and 18%, respectively). The presence of LA was not significantly correlated with cognitive impairment. Only age was positively associated with LA. CONCLUSION: Cranial CT is a trustworthy method for the diagnosis of LA. Only age showed a positive association. No clinical implications were found, concerning the cognitive performance of the patients.

scholarly journals Localization of white-matter lesions and effect of vascular risk factors in late-onset major depression

2009 ◽  
Vol 40 (8) ◽  
pp. 1389-1399 ◽  
Author(s):  
R. B. Dalby ◽  
M. M. Chakravarty ◽  
J. Ahdidan ◽  
L. Sørensen ◽  
J. Frandsen ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Major Depression ◽  
Late Onset ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Lesions ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Lesion Load ◽  
Significant Difference

BackgroundSeveral studies suggest that patients with late-onset major depression (MD) have an increased load of cerebral white-matter lesions (WMLs) compared with age-matched controls. Vascular risk factors such as hypertension and smoking may confound such findings. Our aim was to investigate the association between the localization and load of WMLs in late-onset MD with respect to vascular risk factors.MethodWe examined 22 consecutive patients with late-onset first-episode MD and 22 age- and gender-matched controls using whole-brain magnetic resonance imaging (MRI). The localization, number and volume of WMLs were compared between patients and controls, while testing the effect of vascular risk factors.ResultsAmong subjects with one or more WMLs, patients displayed a significantly higher WML density in two white-matter tracts: the left superior longitudinal fasciculus and the right frontal projections of the corpus callosum. These tracts are part of circuitries essential for cognitive and emotional functions. Analyses revealed no significant difference in the total number and volume of WMLs between groups. Patients and controls showed no difference in vascular risk factors, except for smoking. Lesion load was highly correlated with smoking.ConclusionsOur results indicate that lesion localization rather than lesion load differs between patients with late-onset MD and controls. Increased lesion density in regions associated with cognitive and emotional functions may be crucial in late-onset MD, and vascular risk factors such as smoking may play an important role in the pathophysiology of late-onset MD, consistent with the vascular depression hypothesis.

Conventional vascular risk factors: Their role in the association between migraine and cardiovascular diseases

Cephalalgia ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 146-164 ◽  
Author(s):  
Simona Sacco ◽  
Francesca Pistoia ◽  
Diana Degan ◽  
Antonio Carolei
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Young Patients ◽  
Vascular Risk Factors ◽  
The Body ◽  
Final Conclusion ◽  
Vascular Risk ◽  
Multiple Sources ◽  
Increased Risk

Introduction Migraine, in particular migraine with aura, has been found to be associated with cardiovascular disease. However, the role of conventional vascular risk factors in the association is still debated. The aim of the present review is to address the association between migraine and conventional cardiovascular risk factors as well as to address their possible role in the association between migraine and cardiovascular disease. Methods Data for this review were obtained through searches in multiple sources up to May 2014 using the terms “migraine” OR “headache” in combination with all the vascular risk factors of interest. Results Data about the possible association between migraine and high blood pressure values are heterogeneous, hindering any final conclusion. Data addressing the possible association between migraine and diabetes mellitus indicate the lack of any association or in some cases a negative association between the two conditions. The body of evidence on the role of dyslipidemia in migraineurs is relatively homogeneous and, with few exceptions, reports an association between migraine and an unfavorable lipid profile; however, the difference in lipid levels between migraineurs and non-migraineurs is small and its clinical implication unclear. Regarding obesity, a trend has been observed of increased risk of migraine with increasing obesity, especially in young patients, albeit in the midst of conflicting data. Evidence about the association between cigarette smoking and migraine mostly indicates that migraineurs are more commonly smokers than non-migraineurs. On the other hand, the majority of the available studies report less alcohol use in migraineurs than in non-migraineurs. Finally, many of the available studies suggest a more frequent family history of cardiovascular disease in migraineurs as compared to non-migraineurs. Since most of the studies that supported the association between migraine and cardiovascular disease adjusted the analyses for the presence of several vascular risk factors, they cannot entirely explain this association. Conclusions Based on the available reported data, it seems unlikely that the higher risk of cardiovascular disease in migraineurs is mediated by any single vascular risk factor. For this reason the role of specific interactions among risk factors with the contribution of genetic, environmental, personality and psychological factors should be appropriately investigated.

scholarly journals Markers of atherosclerosis lipoprotein-associated phospholipase A2 and E-selectin and vascular risk factors in patients with carotid stenosis

2021 ◽  
pp. 16-21
Author(s):  
Olga Dubenko ◽  
Victoria Anysienkova
Keyword(s):  
Risk Factors ◽  
Serum Level ◽  
Phospholipase A2 ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
Vascular Risk Factors ◽  
Control Group ◽  
Vascular Risk ◽  
Stroke Risk Factor ◽  
Atherosclerotic Stenosis

The aim of this study is to evaluate serum level biomarkers of atherosclerosis lipoprotein-associated phospholipase A2 and E-selectin in patients with atherosclerotic carotid stenosis with different clinical manifestation in associated with vascular risk factors. Materials and methods: A total 106 patients with atherosclerotic carotid stenosis (74 men and 32 women, aged from 31 to 74 years, mean 62.6±0.9) were included: with acute ipsilateral atherothrombotic stroke (35), history of stroke and carotid endarterectomy (41) and 30 patients with asymptomatic carotid stenosis. The control group consist of 20 health subjects without cardiovascular disease. All participants underwent duplex sonography. Lipoprotein-associated phospholipase A2 and E-selectin was measured using commercially available (ELISA) kit. Results: The level of lipoprotein-associated phospholipase A2 was in general 55.664±3.537 ng/ml, which was significantly higher (M-W U=10, p=1.023136´10-11 <0.05) than in the control group (9.296±0.935 ng/ml). Level was significantly higher in groups of symptomatic patients who underwent carotid endarterectomy (p=0.04893), and proportion patients with high degree stenosis >70 % was greater in this group. The level of E-selectin in the study patients was significantly higher (7.653±0.246 pg/ml) than in the control group (3.101±0.503 pg/ml) p<0.05. No association the serum level of lipoprotein-associated phospholipase A2 and E-selectin with common stroke risk factor such as hypercholesterinemia, smoking and body mass index were found, but positive correlation of lipoprotein-associated phospholipase A2 with E-selectin was significant (p=0.00085). Conclusions: Increasing plasma level lipoprotein-associated phospholipase A2 and E-selectin in patients with the carotid atherosclerotic stenosis were observe. Statistically significant correlation between the level of lipoprotein-associated phospholipase A2 and E-selectin were found in symptomatic carotid atherosclerotic stenosis

scholarly journals A Four-Year Observational Study regarding the Characteristics and Causes of the Ischemic Stroke in Young Adults: one center study report

2020 ◽  
pp. 491-493
Author(s):  
Cătălin Cosmin MUTU ◽  
Marius-Ionuț GHINCEA ◽  
Corina SUCIU ◽  
Vlad SUCIU
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Young Patients ◽  
Carotid Artery Dissection ◽  
Vascular Risk Factors ◽  
Artery Dissection ◽  
Vascular Risk ◽  
Stroke Subtype ◽  
Toast Classification ◽  
Stroke In Young

Introduction. Stroke is the second cause of mortality worldwide, after the ischemic coronary disease, and the first cause of long term-disability. Recent studies report that ischemic stroke (IS) in young patients is increasing in incidence, even though the overall stroke hospitalization rate is decreasing. Stroke in the young, working individuals significantly affects the quality of life (QoL) and also determines an important, negative economic impact by reducing the workforce. Material and method. The aim of this paper is to present the results of a 4-year observational, retrospective study on all patients between 18-49 years, who suffered from acute IS and were admitted and investigated in the Neurology Clinic of Sibiu and the CVASIC Research Center. Clinical evaluations, imaging investigations, and risk factor evaluations were performed on all patients in order to elucidate the etiology and organize according to the TOAST classification. Results and discussions. 114 patients with ischemic stroke were included in the study. 76% of the subjects fall into the 40-49 age class. In respect to the TOAST classification, most cases of IS were of UE (rural<urban), while the fewest cases of IS were represented by SAA in both populations. The most frequent vascular risk factors were hypertension, dyslipidemia, smoking and thrombophilia. Confirmed cervical arteries dissection caused 2/3 of the severe carotid stenosis and 45,5% of the carotid occlusions. Conclusions. Hypertension, dyslipidemia and smoking are the main risk factors for stroke in young patients. The most common TOAST stroke subtype was stroke of undetermined etiology, followed by stroke of other determined etiology (carotid artery dissection and thrombophilia). Keywords: ischemic stroke, young patients, vascular risk factors, TOAST classification, disability,

scholarly journals Cognitive impairment and intracranial atherosclerotic stenosis in general population

Neurology ◽  
2018 ◽  
Vol 90 (14) ◽  
pp. e1240-e1247 ◽  
Author(s):  
M. Fareed K. Suri ◽  
Jincheng Zhou ◽  
Ye Qiao ◽  
Haitao Chu ◽  
Adnan I. Qureshi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Expert Panel ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Atherosclerosis Risk In Communities ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis ◽  
Atherosclerosis Risk ◽  
History Of

ObjectiveTo investigate the association between asymptomatic intracranial atherosclerosis and cognitive impairment in the Atherosclerosis Risk in Communities (ARIC) cohort.MethodsARIC participants underwent high-resolution 3T magnetic resonance angiography and a neuropsychology battery and neurologic examination adjudicated by an expert panel to detect mild cognitive impairment (MCI) and dementia. We adjusted for demographic and vascular risk factors in weighted logistic regression analysis, accounting for stratified sampling design and attrition, to determine the association of intracranial atherosclerotic stenosis (ICAS) with cognitive impairment.ResultsIn 1,701 participants (mean age 76 ± 5.3, 41% men, 71% whites, 29% blacks) with adequate imaging quality and no history of stroke, MCI was identified in 578 (34%) and dementia in 79 (4.6%). In white participants, after adjustment for demographic and vascular risk factors, ICAS ≥50% (vs no ICAS) was strongly associated with dementia (odds ratio [OR] 4.1, 95% confidence interval [CI] 1.7–10.0) and with any cognitive impairment (OR 1.7, 95% CI 1.1–2.8). In contrast, no association was found between ICAS ≥50% and MCI or dementia in blacks, although the sample size was limited and estimates were imprecise.ConclusionOur results suggest that asymptomatic ICAS is independently associated with cognitive impairment and dementia in whites.

Abstract WP450: Cognitive Impairment and Asymptomatic Intracranial Atherosclerotic Stenosis in General Population

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
M.Fareed K. Suri ◽  
Jincheng Zhou ◽  
Ye Qiao ◽  
Haitao Chu ◽  
Adnan I Qureshi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
African Americans ◽  
Previous History ◽  
Vascular Risk Factors ◽  
Intracranial Atherosclerosis ◽  
Vascular Risk ◽  
Atherosclerosis Risk In Communities ◽  
Intracranial Atherosclerotic Stenosis ◽  
Atherosclerotic Stenosis

Background: There is growing evidence suggesting that intracranial atherosclerosis is associated with cognitive impairment. We investigated the association between asymptomatic intracranial atherosclerosis and cognitive impairment in the bi-racial Atherosclerosis Risk in Communities (ARIC) cohort. Methods: ARIC participants who underwent high-resolution 3T magnetic resonance angiography, and a neuropsychology battery and neurological examination adjudicated by an expert panel, to detect mild cognitive impairment (MCI) and dementia. We adjusted for demographic and vascular risk factors in weighted logistic regression analysis, accounting for stratified sampling design and attrition, to determine the association of intracranial atherosclerotic stenosis (ICAS) with cognitive impairment. Results: In 1705 participants (mean age 76 ± 5.3, 41% men, 71% Whites and 29% African-Americans) with adequate imaging quality and no previous history of stroke, MCI was identified in 578 (34%) and dementia in 79 (4.6%). In white participants, after adjustment for demographic and vascular risk factors, ICAS ≥50% (vs no ICAS) was strongly associated with dementia (odds ratio [OR] 4.1, 95% confidence interval [CI] 1.7-10) and with any-cognitive impairment (OR 1.7, 95% CI 1.06 - 2.8). In contrast, no association was found between ICAS ≥50% and MCI or dementia in African-Americans, though sample size was limited and estimates were imprecise. Conclusion: Our results suggest asymptomatic ICAS is independently associated with cognitive impairment and dementia in Whites

scholarly journals Risk factors of the first stroke

2015 ◽  
Vol 68 (1-2) ◽  
pp. 17-21 ◽  
Author(s):  
Sinisa Djuricic ◽  
Rabi Zikic ◽  
Milorad Zikic
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Atrial Fibrillation ◽  
Heart Diseases ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Common Risk Factor ◽  
Factors Associated ◽  
Gender And Age ◽  
Significant Difference

Introduction. This study was aimed at investigating the vascular risk factors associated with the first stroke. It highlighted unfavorable trends in stroke mortality in the region gravitating towards the general hospital in Doboj. Material and Methods. The study included all patients hospitalized with the diagnosis of first stroke and their main vascular risk factors were explored, both in terms of their importance in the occurrence of stroke, and in terms of gender and age lines. The research results were statistically processed, analyzed and commented on. Results. The most common risk factor for the first stroke included hypertension (70%), smoking (35%), heart diseases (28%), diabetes mellitus (28%), hyperlipoproteinemia (26%), atrial fibrillation (18.5%) and immoderate consumption of alcohol (17%). Conclusion. The presence of vascular risk factors in the majority of patients is important, and at least one of them was present in 80% of patients. Alcohol consumption, smoking and hyperlipoproteinemia were significantly more freqeunt in men, and atrial fibrillation was more frequent in women. Arterial hypertension, heart disease and diabetes mellitus were present in both sexes without a significant difference.

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