Basilar Artery Occlusion in Young Adults

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Title: Basilar Artery Occlusion in Young Adults
Author: Koskela, Ilkka
Other contributor: Helsingin yliopisto, Lääketieteellinen tiedekunta, Biolääketieteen laitos
University of Helsinki, Faculty of Medicine, Institute of Biomedicine
Helsingfors universitet, Medicinska fakulteten, Biomedicinska institutionen
Publisher: Helsingfors universitet
Date: 2014
Language: eng
Thesis level:
Discipline: Neurology
Abstract: Basilar artery occlusion (BAO) is one of the most severe neurological diseases associated with high mortality and morbidity. According to previous studies, aetiology, risk factors and outcome of BAO differ from other stroke subtypes, and little information exists on the characteristics of young adult BAO patients. This study is a retrospective observational case-control study of a large registry of consecutive young adult stroke patients (aged 15 to 49 years) treated in the Helsinki University Central Hospital between 1994 and 2007, first describing in detail the risk factors, aetiology, symptom severity and subsequent mortality and disability of young adult BAO-patients, and comparing them with other young adult stroke patients. We found that smoking is significantly less common in BAO patients than in non-BAO-patients (25% vs 45.2%, respectively), large artery atherosclerosis and vertebral or basilar artery dissection are significantly more common in BAO-patients than in non-BAO-patients (25% vs 7.8% and 32.2% vs 7.8%) whereas cardioembolisms, small vessel disease, and internal carotid artery dissection were significantly less common in BAO-patients. Stroke symptoms were significantly more difficult in BAO patients vs non-BAO patients (NIHSS medians 9 [range 0-35] vs 3 [range 0-30]) and follow-up disability defined by the modified Rankin Scale was significantly higher in BAO -patients (good outcome of mRS 0-2 in 53.6% of BAO patients vs 82.3% in non-BAO-patients at 3 months) along with mortality (BAO vs non-BAO-patients 28.6% vs 14.7%). Further development in diagnostics, treatments and rehabilitation is needed to manage BAO in young adult patients.

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