Browsing by Subject "cerebral infarction"

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  • Tolppanen, Heli (Helsingfors universitet, 2010)
    Ischemic stroke in young adults with patent foramen ovale (PFO) and/or atrial septal aneurysm is underinvestigated. Methods: We investigated 86 such patients (age 16-49 years) with long-term follow-up. Results: Most patients recovered well, one died and 15 retired prematurely due to the index stroke. Seven patients underwent PFO closure. Few stroke recurrences occurred (4%) either on aspirin or warfarin during the 6.5 years of follow-up. Conclusions: Our data suggest good outcome, low morbidity, and low recurrence. Finding the best secondary prevention measures requires randomized trials.
  • Kloss, M.; Kalashnikova, L.; Dobrynina, L.; Traenka, C.; Engelter, S. T.; Metso, T. M.; Tatlisumak, T.; Urbanek, C.; Grau, A.; Kellert, L.; Brandt, T.; Wieker, C. M.; Grond-Ginsbach, C.; Pezzini, A. (2020)
    Background and purpose Most recurrent cervical artery dissection (CeAD) events occur shortly after the acute first CeAD. This study compared the characteristics of recurrent and first CeAD events and searched for associations between subsequent events of an individual person. Methods Cervical artery dissection patients with a new CeAD event occurring during a 3-6 month follow-up were retrospectively selected in seven specialized stroke centers. Clinical and vascular characteristics of the initial and the recurrent CeADs were compared. Results The study sample included 76 patients. Recurrent CeADs were occlusive in one (1.3%) patient, caused cerebral ischaemia in 13 (17.1%) and were asymptomatic in 39 (51.3%) patients, compared to 29 (38.2%) occlusive, 42 (55.3%) ischaemic and no asymptomatic first CeAD events. In 52 (68.4%) patients, recurrent dissections affected both internal carotid arteries or both vertebral arteries, whilst 24 (31.6%) patients had subsequent dissections in both types of artery. Twelve (28.6%) of 42 patients with an ischaemic first dissection had ischaemic symptoms due to the recurrent CeADs, too. However, only one (1.3%) of 34 patients with a non-ischaemic first CeAD suffered ischaemia upon recurrence. Conclusion Recurrent CeAD typically affects the same site of artery. It causes ischaemic events less often than the first CeAD. The risk that patients who presented with solely non-ischaemic symptoms of a first CeAD will have ischaemic symptoms in the case of a recurrent CeAD seems very small.
  • Kurkinen, Minna (Helsingfors universitet, 2010)
    We investigated the features of and risk factors for magnetic resonance imaging(MRI)-defined SBIs and leukoaraiosis in 1008 consecutive adults aged 15-49 years with first-ever ischemic stroke.We analyzed the radiologic features of SBIs and leukoaraiosis in MR-scanned patients (n=669) and examined their relation with subtype of the overt stroke. Of the 669 patients included, 13%had SBIs, 7% leukoaraiosis, 3% had both, and 550 free of these served as controls. Most of SBIs were located in basal ganglia (39%) or subcortical regions (21%), but cerebellar SBIs were also rather frequent (15%). Leukoaraiosis was mainly mild to moderate. Risk factors for SBIs were type 1 diabetes, obesity, smoking, and increasing age. Risk factors for leukoaraiosis were type 1 diabetes, obesity, female sex, and increasing age. Small-vessel disease was the predominant cause of stroke in both groups. Thus SBIs and leukoaraiosis are not uncommon among young stroke patients-type 1 diabetes being the strongest risk factor.