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Risk Factors and Causes of Ischemic Stroke in 1322 Young Adults.
Ekker, Merel S; Verhoeven, Jamie I; Schellekens, Mijntje M I; Boot, Esther M; van Alebeek, Mayte E; Brouwers, Paul J A M; Arntz, Renate M; van Dijk, Gert W; Gons, Rob A R; van Uden, Inge W M; den Heijer, Tom; de Kort, Paul L M; de Laat, Karlijn F; van Norden, Anouk G W; Vermeer, Sarah E; van Zagten, Marian S G; van Oostenbrugge, Robert J; Wermer, Marieke J H; Nederkoorn, Paul J; Zonneveld, Thomas P; Kerkhoff, Henk; Rooyer, Fergus A; van Rooij, Frank G; van den Wijngaard, Ido R; Klijn, Catharina J M; Tuladhar, Anil M; de Leeuw, Frank-Erik.
Afiliación
  • Ekker MS; Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (M.S.E., J.I.V., M.M.I.S., E.M.B., C.J.M.K., A.M.T., F.-E.d.L.).
  • Verhoeven JI; Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (M.S.E., J.I.V., M.M.I.S., E.M.B., C.J.M.K., A.M.T., F.-E.d.L.).
  • Schellekens MMI; Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (M.S.E., J.I.V., M.M.I.S., E.M.B., C.J.M.K., A.M.T., F.-E.d.L.).
  • Boot EM; Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (M.S.E., J.I.V., M.M.I.S., E.M.B., C.J.M.K., A.M.T., F.-E.d.L.).
  • van Alebeek ME; Department of Neurology, Amphia Hospital, Breda, the Netherlands (M.E.v.A., A.G.W.v.N).
  • Brouwers PJAM; Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands (P.J.A.M.B., R.M.A.).
  • Arntz RM; Department of Neurology, Medisch Spectrum Twente, Enschede, the Netherlands (P.J.A.M.B., R.M.A.).
  • van Dijk GW; Department of Neurology, Canisius-Wilhelmina Hospital, Nijmegen, the Netherlands (G.W.v.D.).
  • Gons RAR; Department of Neurology, Catharina Hospital, Eindhoven, the Netherlands (R.A.R.G., I.W.M.v.U).
  • van Uden IWM; Department of Neurology, Catharina Hospital, Eindhoven, the Netherlands (R.A.R.G., I.W.M.v.U).
  • den Heijer T; Department of Neurology, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands (T.d.H.).
  • de Kort PLM; Department of Neurology, Elisabeth-TweeSteden Hospital, Tilburg (P.L.M.d.K.).
  • de Laat KF; Department of Neurology, Haga Hospital, The Hague, Netherlands (K.F.d.L.).
  • van Norden AGW; Department of Neurology, Amphia Hospital, Breda, the Netherlands (M.E.v.A., A.G.W.v.N).
  • Vermeer SE; Department of Neurology, Rijnstate Hospital, Arnhem, the Netherlands (S.E.V.).
  • van Zagten MSG; Department of Neurology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands (M.S.G.v.Z.).
  • van Oostenbrugge RJ; Department of Neurology, Maastricht University Medical Centre, Maastricht, the Netherlands (R.J.v.O.).
  • Wermer MJH; Department of Neurology, Leiden University Medical Centre, Leiden, the Netherlands (M.J.H.W.).
  • Nederkoorn PJ; Department of Neurology, Amsterdam University Medical Centres, Amsterdam, the Netherlands (P.J.N., T.P.Z.).
  • Zonneveld TP; Department of Neurology, Amsterdam University Medical Centres, Amsterdam, the Netherlands (P.J.N., T.P.Z.).
  • Kerkhoff H; Department of Neurology, Albert Schweitzer Hospital, Dordrecht, the Netherlands (Henk Kerkhoff, MD, PhD).
  • Rooyer FA; Department of Neurology, Zuyderland Hospital, Sittard-Geleen, the Netherlands (F.A.R.).
  • van Rooij FG; Department of Neurology, Medical Centre Leeuwarden, Leeuwarden, the Netherlands (F.G.v.R.).
  • van den Wijngaard IR; Department of Neurology, Haaglanden Medical Center, the Hague, the Netherlands (I.R.v.d.W.).
  • Klijn CJM; Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (M.S.E., J.I.V., M.M.I.S., E.M.B., C.J.M.K., A.M.T., F.-E.d.L.).
  • Tuladhar AM; Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (M.S.E., J.I.V., M.M.I.S., E.M.B., C.J.M.K., A.M.T., F.-E.d.L.).
  • de Leeuw FE; Department of Neurology, Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, the Netherlands (M.S.E., J.I.V., M.M.I.S., E.M.B., C.J.M.K., A.M.T., F.-E.d.L.).
Stroke ; 54(2): 439-447, 2023 Feb.
Article en En | MEDLINE | ID: mdl-36511150
BACKGROUND: Identification of risk factors and causes of stroke is key to optimize treatment and prevent recurrence. Up to one-third of young patients with stroke have a cryptogenic stroke according to current classification systems (Trial of ORG 10172 in Acute Stroke Treatment [TOAST] and atherosclerosis, small vessel disease, cardiac pathology, other causes, dissection [ASCOD]). The aim was to identify risk factors and leads for (new) causes of cryptogenic ischemic stroke in young adults, using the pediatric classification system from the IPSS study (International Pediatric Stroke Study). METHODS: This is a multicenter prospective cohort study conducted in 17 hospitals in the Netherlands, consisting of 1322 patients aged 18 to 49 years with first-ever, imaging confirmed, ischemic stroke between 2013 and 2021. The main outcome was distribution of risk factors according to IPSS classification in patients with cryptogenic and noncryptogenic stroke according to the TOAST and ASCOD classification. RESULTS: The median age was 44.2 years, and 697 (52.7%) were men. Of these 1322 patients, 333 (25.2%) had a cryptogenic stroke according to the TOAST classification. Additional classification using the ASCOD criteria reduced the number patients with cryptogenic stroke from 333 to 260 (19.7%). When risk factors according to the IPSS were taken into account, the number of patients with no potential cause or risk factor for stroke reduced to 10 (0.8%). CONCLUSIONS: Among young adults aged 18 to 49 years with a cryptogenic ischemic stroke according to the TOAST classification, risk factors for stroke are highly prevalent. Using a pediatric classification system provides new leads for the possible causes in cryptogenic stroke, and could potentially lead to more tailored treatment for young individuals with stroke.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Accidente Cerebrovascular / Aterosclerosis / Accidente Cerebrovascular Isquémico Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Child / Female / Humans / Male Idioma: En Revista: Stroke Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Accidente Cerebrovascular / Aterosclerosis / Accidente Cerebrovascular Isquémico Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Child / Female / Humans / Male Idioma: En Revista: Stroke Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos