Dolichoectasia and Small Vessel Disease in Young Patients With Transient Ischemic Attack and Stroke

被引：38

作者：

Thijs, Vincent ^{[1
,2
]}

Grittner, Ulrike ^{[3
,4
]}

Fazekas, Franz ^{[5
]}

McCabe, Dominick J. H. ^{[7
,8
,9
]}

Giese, Anne-Katrin ^{[10
]}

Kessler, Christof ^{[11
]}

Martus, Peter ^{[12
]}

Norrving, Bo ^{[13
]}

Ringelstein, Erich Bernd ^{[14
]}

Schmidt, Reinhold ^{[5
]}

Tanislav, Christian ^{[15
]}

Putaala, Jukka ^{[16
,17
]}

Tatlisumak, Turgut ^{[16
,17
,18
,19
]}

von Sarnowski, Bettina ^{[11
]}

Rolfs, Arndt ^{[10
]}

Enzinger, Christian ^{[5
,6
]}

机构：

[1] Univ Melbourne, Florey Inst Neurosci & Mental Hlth, Stroke Div, Heidelberg, Vic, Australia

[2] Austin Hlth, Dept Neurol, Heidelberg, Vic, Australia

[3] Charite Univ Med Ctr Berlin, Ctr Stroke Res, Berlin, Germany

[4] Charite Univ Med Ctr Berlin, Dept Biostat & Clin Epidemiol, Berlin, Germany

[5] Med Univ Graz, Dept Neurol, Graz, Austria

[6] Med Univ Graz, Div Neuroradiol, Dept Radiol, Graz, Austria

[7] Adelaide & Meath Hosp, Dept Neurol, Dublin, Ireland

[8] UCL Inst Neurol, Dept Clin Neurosci, Royal Free Campus, London, England

[9] Trinity Coll Dublin, Sch Med, Acad Unit Neurol, Dublin, Ireland

[10] Univ Rostock, Ctr Mental Hlth Dis, Albrecht Kossel Inst Neuroregenerat AKos, Rostock, Germany

[11] Ernst Moritz Arndt Univ Greifswald, Univ Med Greifswald, Dept Neurol, Greifswald, Germany

[12] Inst Klin Epidemiol & Angew Biometrie IKEaB, Tubingen, Germany

[13] Lund Univ, Dept Clin Neurol Sci, Lund, Sweden

[14] Wilhelms Univ Muenster, Munster, Germany

[15] Justus Liebig Univ Giessen, Dept Neurol, Giessen, Germany

[16] Univ Helsinki, Cent Hosp, Dept Neurol, Helsinki, Finland

[17] Univ Helsinki, Clin Neurosci, Helsinki, Finland

[18] Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Gothenburg, Sweden

[19] Sahlgrens Univ Hosp, Dept Neurol, Gothenburg, Sweden

来源：

STROKE | 2017年 / 48卷 / 09期

关键词：

Fabry disease; hypertension; infarction; stroke; white matter; INTRACRANIAL ARTERIAL DOLICHOECTASIA; FABRY PATIENTS SIFAP1; VERTEBROBASILAR DOLICHOECTASIA; DILATATIVE ARTERIOPATHY; CEREBRAL MICROBLEEDS; RISK; BRAIN;

D O I：

10.1161/STROKEAHA.117.017406

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-We evaluated whether basilar dolichoectasia is associated with markers of cerebral small vessel disease in younger transient ischemic attack and ischemic stroke patients. Methods-We used data from the SIFAP1 study (Stroke in Young Fabry Patients), a large prospective, hospital-based, screening study for Fabry disease in young (<55 years) transient ischemic attack/stroke patients in whom detailed clinical data and brain MRI were obtained, and stroke subtyping with TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment) was performed. Results-Dolichoectasia was found in 508 of 3850 (13.2%) of patients. Dolichoectasia was associated with older age (odds ratio per decade, 1.26; 95% confidence interval, 1.09-1.44), male sex (odds ratio, 1.96; 95% confidence interval, 1.592.42), and hypertension (odds ratio, 1.39; 95% confidence interval, 1.13-1.70). Dolichoectasia was more common in patients with small infarctions (33.9% versus 29.8% for acute lesions, P=0.065; 29.1% versus 16.5% for old lesions, P<0.001), infarct location in the brain stem (12.4% versus 6.9%, P<0.001), and in white matter (27.8% versus 21.1%, P=0.001). Microbleeds (16.3% versus 4.7%, P=0.001), higher grades of white matter hyperintensities (P<0.001), and small vessel disease subtype (18.1% versus 12.4%, overall P for differences in TOAST (P=0.018) were more often present in patients with dolichoectasia. Conclusions-Dolichoectasia is associated with imaging markers of small vessel disease and brain stem localization of acute and old infarcts in younger patients with transient ischemic attack and ischemic stroke.

引用

页码：2361 / +

页数：10

共 21 条

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