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Recurrent cerebrovascular events after recent small subcortical infarction.
Haidegger, Melanie; Klock, Nina; Kneihsl, Markus; Fandler-Höfler, Simon; Eppinger, Sebastian; Eller, Kathrin; Seiler, Stephan; Enzinger, Christian; Gattringer, Thomas.
Afiliación
  • Haidegger M; Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036, Graz, Austria.
  • Klock N; Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036, Graz, Austria.
  • Kneihsl M; Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036, Graz, Austria.
  • Fandler-Höfler S; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
  • Eppinger S; Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036, Graz, Austria.
  • Eller K; Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036, Graz, Austria.
  • Seiler S; Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Graz, Austria.
  • Enzinger C; Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Gattringer T; Department of Neurology, Medical University of Graz, Auenbruggerplatz 22, 8036, Graz, Austria.
J Neurol ; 271(8): 5055-5063, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38802623
ABSTRACT

BACKGROUND:

Recent small subcortical infarcts (RSSI) are the neuroimaging hallmark feature of small vessel disease (SVD)-related acute lacunar stroke. Long-term data on recurrent cerebrovascular events including their aetiology after RSSI are scarce. PATIENTS AND

METHODS:

This retrospective study included all consecutive ischaemic stroke patients with an MRI-confirmed RSSI (in the supply area of a small single brain artery) at University Hospital Graz between 2008 and 2013. We investigated associations between clinical and SVD features on MRI (STRIVE criteria) and recurrent cerebrovascular events, using multivariable Cox regression adjusted for age, sex, vascular risk factors and MRI parameters.

RESULTS:

We analysed 332 consecutive patients (mean age 68 years, 36% women; median follow-up time 12 years). A recurrent ischaemic cerebrovascular event occurred in 70 patients (21.1%; 54 ischaemic strokes, 22 transient ischaemic attacks) and was mainly attributed to SVD (68%). 26 patients (7.8%) developed intracranial haemorrhage. In multivariable analysis, diabetes (HR 2.43, 95% CI 1.44-3.88), severe white matter hyperintensities (HR 1.97, 95% CI 1.14-3.41), and cerebral microbleeds (HR 1.89, 95% CI 1.32-3.14) on baseline MRI were related to recurrent ischaemic stroke/TIA, while presence of cerebral microbleeds increased the risk for intracranial haemorrhage (HR 3.25, 95% CI 1.39-7.59). A widely used SVD summary score indicated high risks of recurrent ischaemic (HR 1.22, 95% CI 1.01-1.49) and haemorrhagic cerebrovascular events (HR 1.57, 95% CI 1.11-2.22).

CONCLUSION:

Patients with RSSI have a substantial risk for recurrent cerebrovascular events-particularly those with coexisting chronic SVD features. Recurrent events are mainly related to SVD again.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Imagen por Resonancia Magnética Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurol Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Recurrencia / Imagen por Resonancia Magnética Límite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: J Neurol Año: 2024 Tipo del documento: Article País de afiliación: Austria Pais de publicación: Alemania