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Title: Dolichoectasia and small vessel disease in young patients with transient ischemic attack and stroke
Austin Authors: Thijs, Vincent N ;Grittner, Ulrike;Fazekas, Franz;McCabe, Dominick JH;Giese, Anne-Katrin;Kessler, Christof;Martus, Peter;Norrving, Bo;Ringelstein, Erich Bernd;Schmidt, Reinhold;Tanislav, Christian;Putaala, Jukka;Tatlisumak, Turgut;von Sarnowski, Bettina;Rolfs, Arndt;Enzinger, Christian;Stroke in Fabry (SIFAP1) Investigators
Affiliation: Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia
Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
Center for Stroke Research and Department of Biostatistics and Clinical Epidemiology, Charité - University Medical Centre Berlin, Germany
Department of Neurology, Medical University of Graz, Austria
Division of Neuroradiology, Department of Radiology, Medical University of Graz, Austria
Department of Neurology, The Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Dublin, Republic of Ireland
Department of Clinical Neurosciences, Royal Free Campus, UCL Institute of Neurology, London, United Kingdom
Academic Unit of Neurology, School of Medicine, Trinity College Dublin, Ireland
Albrecht-Kossel-Institute for Neuroregeneration (AKos) Centre for Mental Health Disease University of Rostock, Germany
Department of Neurology, University Medicine Greifswald, Ernst-Moritz-Arndt-University Greifswald, Germany
Institut für Klinische Epidemiologie und Angewandte Biometrie (IKEaB), Tübingen, Germany
Department of Clinical Sciences Neurology, Lund University, Sweden
Wilhelms University of Muenster, Germany
Department of Neurology, Justus Liebig University Giessen, Germany
Department of Neurology, Helsinki University Central Hospital, Finland
Clinical Neurosciences, University of Helsinki, Finland
Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
Issue Date: 28-Jul-2017 2017-07-28
Publication information: Stroke 2017; 48(9): 2361-2367
Abstract: We evaluated whether basilar dolichoectasia is associated with markers of cerebral small vessel disease in younger transient ischemic attack and ischemic stroke patients. METHODS: We used data from the SIFAP1 study (Stroke in Young Fabry Patients), a large prospective, hospital-based, screening study for Fabry disease in young (<55 years) transient ischemic attack/stroke patients in whom detailed clinical data and brain MRI were obtained, and stroke subtyping with TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment) was performed. RESULTS: Dolichoectasia was found in 508 of 3850 (13.2%) of patients. Dolichoectasia was associated with older age (odds ratio per decade, 1.26; 95% confidence interval, 1.09-1.44), male sex (odds ratio, 1.96; 95% confidence interval, 1.59-2.42), and hypertension (odds ratio, 1.39; 95% confidence interval, 1.13-1.70). Dolichoectasia was more common in patients with small infarctions (33.9% versus 29.8% for acute lesions, P=0.065; 29.1% versus 16.5% for old lesions, P<0.001), infarct location in the brain stem (12.4% versus 6.9%, P<0.001), and in white matter (27.8% versus 21.1%, P=0.001). Microbleeds (16.3% versus 4.7%, P=0.001), higher grades of white matter hyperintensities (P<0.001), and small vessel disease subtype (18.1% versus 12.4%, overall P for differences in TOAST (P=0.018) were more often present in patients with dolichoectasia. CONCLUSIONS: Dolichoectasia is associated with imaging markers of small vessel disease and brain stem localization of acute and old infarcts in younger patients with transient ischemic attack and ischemic stroke. CLINICAL TRIAL REGISTRATION: URL: Unique identifier: NCT00414583.
DOI: 10.1161/STROKEAHA.117.017406
ORCID: 0000-0002-6614-8417
PubMed URL:
Type: Journal Article
Subjects: Fabry disease
White matter
Type of Clinical Study or Trial: Cohort Study
Appears in Collections:Journal articles

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