Silent brain infarcts and leukoaraiosis in young adults with first-ever ischemic stroke  

Oleh:

Putaala, J. ; Kurkinen, M. ; Tarvos, V. ; Salonen, O.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: Neurology (Official Journal of The American Academy of Neurology) vol. 72 no. 21 (May 2009), page 1823-1829.
Topik: TYPE 1 DIABETES; STROKE-LIKE SYMPTOMS

Ketersediaan

Perpustakaan FK Nomor Panggil: N11.K.2009.04 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

Background: We recently observed that 13% of 1,008 consecutive adults aged 15–49 years with first-ever ischemic stroke had one or more silent brain infarcts (SBIs), and more than 5% presented with leukoaraiosis on CT or MRI. We sought to investigate the features of and risk factors for magnetic resonance (MR)-defined SBIs and leukoaraiosis in these patients. Methods: We analyzed the radiologic features of SBIs and leukoaraiosis in MR-scanned patients (n = 669) blinded to clinical data and examined their relation with subtype of the overt stroke. We used logistic regression to identify factors predisposing to SBIs and leukoaraiosis. Results: Of the 669 patients included, 86 (13%) had SBIs, 50 (7%) had leukoaraiosis, 17 (3%) had both, and 550 had no SBIs or leukoaraiosis and served as controls. The majority (54%) had a single SBI, 20% had two SBIs, and 27% had three or more SBIs. Most SBIs were located in basal ganglia (39%) or subcortical regions (21%), but cerebellar SBIs also were rather frequent (15%). Leukoaraiosis was mainly mild to moderate. Independent risk factors for SBIs were type 1 diabetes (odds ratio [OR] 5.78, 95% confidence interval 2.37–14.10), obesity (OR 2.12, 1.07–4.19), smoking (OR 1.69, 1.05–2.72), and increasing age (OR 1.08, 1.04–1.13). Risk factors for leukoaraiosis were type 1 diabetes (OR 9.75, 3.39–28.04), obesity (OR 2.42, 1.04–5.68), female sex (OR 2.25, 1.16–4.34), and increasing age (OR 1.19, 1.10–1.29). Small-vessel disease was the predominant cause of stroke in both those with SBIs (31%) and leukoaraiosis (44%). Conclusions: Silent brain infarcts and leukoaraiosis are not uncommon among young stroke patients—type 1 diabetes being the strongest risk factor.

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