OBJECTIVE: To determine the association between silent ischemic lesions (SILs) on baseline brain MRI and recurrent stroke in young adults with first-ever ischemic stroke. METHODS: This was a single-center retrospective study of adult patients aged 18-50 years with first-ever ischemic stroke investigated by brain MRI between 2002 and 2009. Silent brain infarcts (SBIs) were defined as focal T2 hyperintensities ≥ 3 mm without corresponding focal symptoms, and leukoaraiosis was defined as focal, multifocal, or confluent hyperintensities on T2-weighted sequences. The primary outcome was recurrent stroke. A forward stepwise Cox regression model was used to determine whether SILs were independently associated with recurrent stroke. RESULTS: A total of 271 eligible patients were identified in the database: 89 did not undergo MRI imaging and 12 patients had inadequate follow-up, leaving a study population of 170 patients. MRI demonstrated SILs in 48 of 170 (28.2) patients. No patients had isolated leukoaraiosis. Hypertension (p = 0.049), migraine with aura (p = 0.02), and cardiovascular disease (p = 0.04) were associated with SIL. Mean follow-up duration was 25 ± 7 months. Among patients with SILs, 11 of 48 (23%) had a recurrent stroke vs 8 of 122 (6.5%) patients without SIL (p = 0.003). After multivariate Cox regression, SILs remained independently associated with recurrent stroke (hazard ratio [HR] 3.2, 95% confidence interval [CI] 1.2-8.6, p = 0.02), as did the combination of SBIs and leukoaraiosis (HR 7.3, 95% CI 2.3-22.9, p = 0.003). CONCLUSIONS: In adults ≤ 50 years old with first-ever ischemic stroke, SILs are common and independently predict recurrent stroke.
OBJECTIVE: To determine the association between silent ischemic lesions (SILs) on baseline brain MRI and recurrent stroke in young adults with first-ever ischemic stroke. METHODS: This was a single-center retrospective study of adult patients aged 18-50 years with first-ever ischemic stroke investigated by brain MRI between 2002 and 2009. Silent brain infarcts (SBIs) were defined as focal T2 hyperintensities ≥ 3 mm without corresponding focal symptoms, and leukoaraiosis was defined as focal, multifocal, or confluent hyperintensities on T2-weighted sequences. The primary outcome was recurrent stroke. A forward stepwise Cox regression model was used to determine whether SILs were independently associated with recurrent stroke. RESULTS: A total of 271 eligible patients were identified in the database: 89 did not undergo MRI imaging and 12 patients had inadequate follow-up, leaving a study population of 170 patients. MRI demonstrated SILs in 48 of 170 (28.2) patients. No patients had isolated leukoaraiosis. Hypertension (p = 0.049), migraine with aura (p = 0.02), and cardiovascular disease (p = 0.04) were associated with SIL. Mean follow-up duration was 25 ± 7 months. Among patients with SILs, 11 of 48 (23%) had a recurrent stroke vs 8 of 122 (6.5%) patients without SIL (p = 0.003). After multivariate Cox regression, SILs remained independently associated with recurrent stroke (hazard ratio [HR] 3.2, 95% confidence interval [CI] 1.2-8.6, p = 0.02), as did the combination of SBIs and leukoaraiosis (HR 7.3, 95% CI 2.3-22.9, p = 0.003). CONCLUSIONS: In adults ≤ 50 years old with first-ever ischemic stroke, SILs are common and independently predict recurrent stroke.
Authors: Jan W Schrickel; Markus Linhart; Dietmar Bänsch; Daniel Thomas; Georg Nickenig Journal: Clin Res Cardiol Date: 2015-10-29 Impact factor: 5.460
Authors: Pınar Aslan Koşar; Muhammet Yusuf Tepebaşı; Nihat Şengeze; İlter İlhan; Halil İbrahim Büyükbayram; Süleyman Kutluhan Journal: Mol Biol Rep Date: 2021-05-21 Impact factor: 2.316
Authors: Ilko L Maier; Katharina Schregel; André Karch; Mark Weber-Krueger; Rafael T Mikolajczyk; Raoul Stahrenberg; Klaus Gröschel; Mathias Bähr; Michael Knauth; Marios-Nikos Psychogios; Rolf Wachter; Jan Liman Journal: Stroke Res Treat Date: 2017-04-27
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