Ischemic Infarction in Young Adults: A Review for                     Radiologists

McCarty, Jennifer; Leung, Lester Y.; Peterson, Ryan B.; Sitton, Clark; Sarraj, Amrou; Riascos, Roy F.; Brinjikji, Waleed

doi:10.1148/rg.2019190033

Cited by 18 publications

(16 citation statements)

References 55 publications

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“…Management of stroke risk factors is considered as the best strategy to decrease the incidence of ischemic stroke [2]. Notably, the etiology of ischemic stroke differs signi cantly between young and older patients [2][3][4]. Several previous studies have indicated that smoking, hypertension, and diabetes are common risk factors in young patients with ischemic stroke [5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Several previous studies have indicated that smoking, hypertension, and diabetes are common risk factors in young patients with ischemic stroke [5][6]. Some cardiac and vascular diseases, such as arrhythmia, cerebral artery dissection, and small vessel disease, were also common causes in young ischemic stroke patients [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Although several risk factors have been discovered, over a third of ischemic strokes in young adults remain cryptogenic, which hints at an inadequate understanding of the pathogenesis of ischemic stroke in young adults [2][3][4]. Therefore, identifying novel risk factors and understanding the pathogenesis of ischemic stroke in young adults is urgent and important.…”

Section: Introductionmentioning

confidence: 99%

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Serum Metabolomic Patterns in Young Patients with Ischemic Stroke

Liu

Yuan

Zhao

et al. 2020

Preprint

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Background: Ischemic stroke is one of the leading causes of death and adult disability. The incidence of ischemic stroke continues to rise in young adults. This study aimed to provide a comprehensive evaluation of metabolic changes and explore possible mechanisms in young ischemic stroke patients without common risk factors. Methods: This study investigated serum metabolomics in 50 young patients with newly suffered ischemic stroke and 50 age-, sex-, and body mass index–matched healthy controls. The metabolomic data were analyzed by performing a multivariate statistical analysis.Results: The 197 metabolites, including amino acids, bile acids, free fatty acids, and lipids, were identified in all participants. Multivariate models showed significant differences in serum metabolomic patterns between young patients with ischemic stroke and healthy controls. The stroke patients had increased L-methionine, homocysteine, glutamine, uric acid, GCDCA, and PE (18:0/20:4, 16:0/22:5), and decreased levels of L-citrulline, taurine, PC (16:2/22:6, 16:2/20:5, 15:0/18:2), and SM (d18:1/23:0, d20:0/19:1, d18:1/22:0, d16:0/26:1, d16:0/18:0, d16:0/22:1, d18:1/19:1, d16:0/17:1, d16:1/24:1, d18:1/19:0). Based on the identified metabolites, the metabolic pathways of arginine biosynthesis, glycerophospholipid metabolism, and taurine and hypotaurine metabolism were significantly enriched in the young patients with ischemic stroke. Conclusions: Serum metabolomic patterns were significantly different between young patients with ischemic stroke and healthy controls.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Serum Metabolomic Patterns in Young Patients with Ischemic Stroke

Liu

Yuan

Zhao

et al. 2020

Preprint

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“…53 CMIs are associated with atherosclerosis, and are believed to be of microembolic origin. [54][55][56] Also, CMIs are a new marker of vascular dementia, especially if occurring in strategic locations, such as the inferior frontal and cingulate gyri. 50,52,57 Although CMIs have also been described in the cerebellum on post-mortem 7T MRI studies, the somewhat larger cortical infarct cavities (<1.5 cm) are more frequently observed in that region (Figure 6).…”

Section: Cortical Microinfarctsmentioning

confidence: 99%

“…Also, in case of an ischemic infarct that has been treated with thrombolysis or intra-arterial treatment, there may be local vessel wall enhancement present at the location of the previous occlusion. 54,55 Finally, if a patient has undergone an MRI examination including contrast administration less than 12 hours before vessel wall MRI, there may be residual contrast enhancement on the subsequent 'precontrast' vessel wall images.…”

Section: Clinical Informationmentioning

confidence: 99%

Intracranial Vessel Wall MR Imaging: From Bench to Bedside

Lindenholz¹

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An additional advantage of 7T is the relative ease with which CSF suppression is achieved, something that has not been matched at 3T yet. Finally, high SNRs and CNRs of 7T MRI enable more detailed assessment of other neurological pathology like (micro)infarcts and (micro)bleeds, which together with highly detailed vessel wall MR imaging might provide information on the cerebrovascular status of the individual patient. 27,28 However, the question remains whether these advantages have additional clinical value over data acquired at 3T.Nevertheless, for all its advantages, a major drawback of 7T MRI is that these platforms are only sparsely available, which makes widespread implementation of 7T MRI sequences in clinical practice currently impossible. Therefore, it is important that technical advancements and newly acquired insights can be translated back 14 CHAPTER 1 This ThesisThis thesis will address several of the current caveats in both implementation of intracranial vessel wall MRI sequences and clinical interpretation of imaging transition from research-based knowledge towards a radiological and clinically applicable imaging technique, both at 3T and 7T MRI.

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