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.
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 strokepatients--type 1 diabetes being the strongest risk factor.
Authors: Ralph Weber; Christian Weimar; Isabel Wanke; Claudia Möller-Hartmann; Elke R Gizewski; Jon Blatchford; Karin Hermansson; Andrew M Demchuk; Michael Forsting; Ralph L Sacco; Jeffrey L Saver; Steven Warach; Hans Christoph Diener; Anke Diehl Journal: Stroke Date: 2012-01-19 Impact factor: 7.914
Authors: Laura Fancellu; Walter Borsini; Ilaria Romani; Angelo Pirisi; Giovanni Andrea Deiana; Elia Sechi; Pietro Emiliano Doneddu; Anna Laura Rassu; Rita Demurtas; Anna Scarabotto; Pamela Cassini; Eloisa Arbustini; GianPietro Sechi Journal: BMC Neurol Date: 2015-12-12 Impact factor: 2.474
Authors: S Cocozza; C Russo; A Pisani; G Olivo; E Riccio; A Cervo; G Pontillo; S Feriozzi; M Veroux; Y Battaglia; D Concolino; F Pieruzzi; R Mignani; P Borrelli; M Imbriaco; A Brunetti; E Tedeschi; G Palma Journal: AJNR Am J Neuroradiol Date: 2017-10-19 Impact factor: 3.825
Authors: Fanny P Timm; Timothy T Houle; Stephanie D Grabitz; Anne-Louise Lihn; Janne B Stokholm; Katharina Eikermann-Haerter; Ala Nozari; Tobias Kurth; Matthias Eikermann Journal: BMJ Date: 2017-01-10
Authors: Renate M Arntz; Steffen M A van den Broek; Inge W M van Uden; Mohsen Ghafoorian; Bram Platel; Loes C A Rutten-Jacobs; Noortje A M Maaijwee; Pauline Schaapsmeerders; Hennie C Schoonderwaldt; Ewoud J van Dijk; Frank-Erik de Leeuw Journal: Neurology Date: 2016-08-12 Impact factor: 9.910