Cerebral ischemia in young patients (under 45 years of age):  clinical and neuroradiological follow-up

Cerebral ischemia in young patients (under 45 years of age): clinical and neuroradiological follow-up

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Rosalba Patella • Alessandra Spalloni • Marco Ferrari • Sara La Starza • Alessandro Bozzao • Maurizia Rasura
  • چاپ و سال / کشور: 2011

Description

Ischemic stroke in young patients is a relatively rare event. Few studies have examined the long-term prognosis. The aim of this study was to evaluate the longterm outcome to identify clinical, laboratory and radiologic patterns as possible predictors for mortality, recurrence and functional recovery. We prospectively evaluated 94 patients (42 males and 52 females, aged 14–45 years, mean age 35.5 years, SD 8.4) admitted to our Neurological Department, for first acute ischemic stroke. A 48-month follow-up was performed. The patients were classified according to TOAST and Baltimore classification and Bamford criteria. The severity of the neurological deficit on admission was assessed using the NIHSS. The follow-up included a clinical visit, the modified Ranking scale (mRs) score, Barthel index (BI), and magnetic resonance imaging and intraextracranial vessel Angio MRI. A good functional outcome (mRS 0–1) was found in 74 patients and unfavourable outcome (mRS 2–6) in 20 patients. 16 patients had a recurrent cerebral ischemic event: 5 patients had stroke and 11 patients had TIA. The average incidence annual rate of recurrence was 4.5% and a mortality rate was of 1.06%. Our study does not demonstrate any predictive factor related to clinical outcome. The relevant data of neuroradiological follow-up is the presence of clinically silent lesions in nine patients, considered as a recurrent stroke. To attribute a prognostic role to these lesions, clinical and neuroradiological follow-up needs to be continued.
Neurol Sci (2011) 32:427–432 DOI 10.1007/s10072-011-0507-6 Received: 18 March 2010 / Accepted: 17 February 2011 / Published online: 2 March 2011
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