MRI in acute cerebral ischemia of the Young: the Stroke in Young Fabry Patients (sifap1) Study
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MRI in acute cerebral ischemia of the Young: the Stroke in Young Fabry Patients (sifap1) Study. / Fazekas, Franz; Enzinger, Christian; Schmidt, Reinhold; Dichgans, Martin; Gaertner, Beate; Jungehulsing, Gerhard J; Hennerici, Michael G; Heuschmann, Peter; Holzhausen, Martin; Kaps, Manfred; Kessler, Christof; Martus, Peter; Putaala, Jukka; Ropele, Stefan; Tanislav, Christian; Tatlisumak, Turgut; Norrving, Bo; Rolfs, Arndt; SIFAP 1 Investigators.
in: NEUROLOGY, Jahrgang 81, Nr. 22, 26.11.2013, S. 1914-21.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - MRI in acute cerebral ischemia of the Young: the Stroke in Young Fabry Patients (sifap1) Study
AU - Fazekas, Franz
AU - Enzinger, Christian
AU - Schmidt, Reinhold
AU - Dichgans, Martin
AU - Gaertner, Beate
AU - Jungehulsing, Gerhard J
AU - Hennerici, Michael G
AU - Heuschmann, Peter
AU - Holzhausen, Martin
AU - Kaps, Manfred
AU - Kessler, Christof
AU - Martus, Peter
AU - Putaala, Jukka
AU - Ropele, Stefan
AU - Tanislav, Christian
AU - Tatlisumak, Turgut
AU - Norrving, Bo
AU - Rolfs, Arndt
AU - SIFAP 1 Investigators
AU - Thomalla, Götz
PY - 2013/11/26
Y1 - 2013/11/26
N2 - OBJECTIVE: We focused on cerebral imaging findings in a large cohort of young patients with a symptomatic ischemic cerebrovascular event (CVE) to extract relevant pathophysiologic and clinical information.METHODS: We analyzed the scans of 2,979 patients (aged 18-55 years) enrolled in the sifap1 project with clinical evidence of ischemic stroke (IS) or clinically defined TIA in whom MRI, including diffusion-weighted imaging, was obtained within 10 days of the CVE. Age groups were categorized as 18-34, 35-44, and 45-55 years. We compared age- and sex-specific proportions of infarct features, white matter hyperintensities, and old microbleeds.RESULTS: Acute infarcts were identified in 1,914 of 2,264 patients (84.5%) with IS and 101 of 715 patients (14.1%) with TIA. Among patients with IS, younger age was significantly associated with acute infarcts in the posterior circulation, while anterior circulation infarcts and acute lacunar infarcts were more frequent in older age groups. One or more old infarcts were present in 26.8% of IS and 17.1% of TIA patients. This rate remained high even after excluding patients with a prior CVE (IS, 21.7%; TIA, 9.9%). The prevailing type of old infarction was territorial in patients younger than 45 years and lacunar in those aged 45 years or older. The frequency of white matter hyperintensities (46.4%) and their severity was positively associated with age. Old microbleeds were infrequent (7.2%).CONCLUSIONS: Young adults show a high frequency of preexisting and clinically silent infarcts and a relative preference for acute ischemia in the posterior circulation. Findings suggesting small-vessel disease become apparent at age 45 years and older.
AB - OBJECTIVE: We focused on cerebral imaging findings in a large cohort of young patients with a symptomatic ischemic cerebrovascular event (CVE) to extract relevant pathophysiologic and clinical information.METHODS: We analyzed the scans of 2,979 patients (aged 18-55 years) enrolled in the sifap1 project with clinical evidence of ischemic stroke (IS) or clinically defined TIA in whom MRI, including diffusion-weighted imaging, was obtained within 10 days of the CVE. Age groups were categorized as 18-34, 35-44, and 45-55 years. We compared age- and sex-specific proportions of infarct features, white matter hyperintensities, and old microbleeds.RESULTS: Acute infarcts were identified in 1,914 of 2,264 patients (84.5%) with IS and 101 of 715 patients (14.1%) with TIA. Among patients with IS, younger age was significantly associated with acute infarcts in the posterior circulation, while anterior circulation infarcts and acute lacunar infarcts were more frequent in older age groups. One or more old infarcts were present in 26.8% of IS and 17.1% of TIA patients. This rate remained high even after excluding patients with a prior CVE (IS, 21.7%; TIA, 9.9%). The prevailing type of old infarction was territorial in patients younger than 45 years and lacunar in those aged 45 years or older. The frequency of white matter hyperintensities (46.4%) and their severity was positively associated with age. Old microbleeds were infrequent (7.2%).CONCLUSIONS: Young adults show a high frequency of preexisting and clinically silent infarcts and a relative preference for acute ischemia in the posterior circulation. Findings suggesting small-vessel disease become apparent at age 45 years and older.
KW - Adolescent
KW - Adult
KW - Age Factors
KW - Cerebral Cortex
KW - Cerebral Infarction
KW - Cohort Studies
KW - Europe
KW - Female
KW - Humans
KW - Image Processing, Computer-Assisted
KW - International Cooperation
KW - Ischemic Attack, Transient
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Retrospective Studies
KW - Severity of Illness Index
KW - Sex Factors
KW - Stroke
KW - Young Adult
U2 - 10.1212/01.wnl.0000436611.28210.ec
DO - 10.1212/01.wnl.0000436611.28210.ec
M3 - SCORING: Journal article
C2 - 24186912
VL - 81
SP - 1914
EP - 1921
JO - NEUROLOGY
JF - NEUROLOGY
SN - 0028-3878
IS - 22
ER -