Importance and Repercussions of Renal and Cardiovascular Pathology on Stroke in Young Adults: An Anatomopathologic Study of 52 Clinical Necropsies

Abstract

RESULTS:Hemorrhagic stroke was diagnosed in 36 patients (69.3%), whereas the remaining 16 (30.7%) had ischemic stroke. Hypertensive cardiopathy was evident in 88.4% of the cases. Chronic renal pathology, directly or indirectly related to hypertension, was observed in 55.7% of the patients. Ischemic stroke as a result of occlusive atherosclerotic disease was seen in 50% of cases. Cardiogenic emboli were found in 25% of the cadavers. Hemorrhagic stroke was associated with hypertension in 43% of the cases, with ruptured vascular malformations in 29%, and coagulopathies in 17% of the cases. Hypertensive cardiopathy was present in patients with either ischemic or hemorrhagic stroke (81.2% and 91.6%, respectively). The most frequently observed renal ailments were chronic pyelonephritis (23%) and nephrosclerosis (21.1%). These were associated with ischemic stroke in 43.7%, and 12.5% of the cases, respectively, and with 13.8% and 25% of the hemorrhagic stroke cases. DISCUSSION: Hypertensive cardiopathy, occlusive atherosclerotic disease, chronic pyelonephritis and nephrosclerosis are among the pathophysiologycal mechanisms that apparently and eventually interact to induce a significant number of cases of stroke in young adults. A chronic systemic inflammatory state appears to be an important related condition because it possibly constitutes an accelerant of the pathophysiologycal process.

Polyclonal light chains in cerebrovascular disease

“…They are associated with white matter lesions,12,13 silent brain infarction,14 a high prevalence of stroke,15,16 worse prognosis, in terms of both short- and long-term morbidity and mortality,9,10 and recurrence of vascular events (stroke, myocardial infarction, heart failure) 10. Pathologic renal findings are also described in young patients affected with stroke, mainly related to hypertensive cardiopathy, nephroangiosclerosis, and chronic pyelonephritis 17. Lastly, renal dysfunction is related to cognitive impairment and dementia 18–21…”

“… 10 Pathologic renal findings are also described in young patients affected with stroke, mainly related to hypertensive cardiopathy, nephroangiosclerosis, and chronic pyelonephritis. 17 Lastly, renal dysfunction is related to cognitive impairment and dementia. 18 – 21 …”