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

Thijs, Vincent; Grittner, Ulrike; Fazekas, Franz; McCabe, Dominick J H; Giese, Anne-Katrin; Kessler, Christof; Martus, Peter; Norrving, Bo LU ; Ringelstein, Erich Bernd and Schmidt, Reinhold, et al. (2017) In Stroke 48(9). p.2361-2367
Abstract

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... (More)

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, 1.59-2.42), 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.

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Contribution to journal
publication status
published
subject
keywords
Fabry disease, hypertension, infarction, stroke, white matter
in
Stroke
volume
48
issue
9
pages
7 pages
publisher
American Heart Association
external identifiers
  • scopus:85030418519
  • wos:000408438000031
ISSN
0039-2499
DOI
10.1161/STROKEAHA.117.017406
language
English
LU publication?
yes
id
7b7b3591-cff8-48e2-9805-52368b7305d2
date added to LUP
2017-11-03 08:37:57
date last changed
2018-05-06 04:37:59
@article{7b7b3591-cff8-48e2-9805-52368b7305d2,
  abstract     = {<p>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 (&lt;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, 1.59-2.42), 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&lt;0.001), infarct location in the brain stem (12.4% versus 6.9%, P&lt;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&lt;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.</p>},
  author       = {Thijs, Vincent and Grittner, Ulrike and Fazekas, Franz and McCabe, Dominick J H and Giese, Anne-Katrin and Kessler, Christof and Martus, Peter and Norrving, Bo and Ringelstein, Erich Bernd and Schmidt, Reinhold and Tanislav, Christian and Putaala, Jukka and Tatlisumak, Turgut and von Sarnowski, Bettina and Rolfs, Arndt and Enzinger, Christian and , },
  issn         = {0039-2499},
  keyword      = {Fabry disease,hypertension,infarction,stroke,white matter},
  language     = {eng},
  month        = {09},
  number       = {9},
  pages        = {2361--2367},
  publisher    = {American Heart Association},
  series       = {Stroke},
  title        = {Dolichoectasia and Small Vessel Disease in Young Patients with Transient Ischemic Attack and Stroke},
  url          = {http://dx.doi.org/10.1161/STROKEAHA.117.017406},
  volume       = {48},
  year         = {2017},
}