Pathogenetic profile of TIA before 55

Mettinger, K.L.; Söderström, C.E.

doi:10.1016/0022-510x(78)90042-4

Cited by 21 publications

(7 citation statements)

References 19 publications

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“…However, when patients presenting with subarachnoid hemorrhage were excluded, the prevalence of intracranial aneurysms was only 7.3%, much lower than the 22% to 51% prevalence reported by other investigators. 16,19,28,36,43 This may explain the reported low prevalence of subarachnoid hemorrhage (5 patients) in this series.…”

Section: Olin Et Almentioning

confidence: 71%

The United States Registry for Fibromuscular Dysplasia

et al. 2012

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Background-Fibromuscular dysplasia (FMD), a noninflammatory disease of medium-size arteries, may lead to stenosis, occlusion, dissection, and/or aneurysm. There has been little progress in understanding the epidemiology, pathogenesis, and outcomes since its first description in 1938. Methods and Results-Clinical features, presenting symptoms, and vascular events are reviewed for the first 447 patients enrolled in a national FMD registry from 9 US sites. Vascular beds were imaged selectively based on clinical presentation and local practice. The majority of patients were female (91%) with a mean age at diagnosis of 51.9 (SD 13.4 years; range, 5-83 years). Hypertension, headache, and pulsatile tinnitus were the most common presenting symptoms of the disease. Self-reported family history of stroke (53.5%), aneurysm (23.5%), and sudden death (19.8%) were common, but FMD in firstor second-degree relatives was reported only in 7.3%. FMD was identified in the renal artery in 294 patients, extracranial carotid arteries in 251 patients, and vertebral arteries in 82 patients. A past or presenting history of vascular events were common: 19.2% of patients had a transient ischemic attack or stroke, 19.7% had experienced arterial dissection(s), and 17% of patients had an aneurysm(s). The most frequent indications for therapy were hypertension, aneurysm, and dissection. Conclusions-In this registry, FMD occurred primarily in middle-aged women, although it presents across the lifespan.Cerebrovascular FMD occurred as frequently as renal FMD. Although a significant proportion of FMD patients may present with a serious vascular event, many present with nonspecific symptoms and a subsequent delay in diagnosis. (Circulation. 2012;125:3182-3190.)

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Section: Olin Et Almentioning

confidence: 71%

The United States Registry for Fibromuscular Dysplasia

et al. 2012

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“…More focal and specific neurologic signs and symptoms that may occur include transient ischemic attack (TIA), cerebral infarction, subarachnoid hemorrhage, syncope, Horner syndrome, and cranial nerve palsies. 10,18,36 Symptoms may be related to one or more of the following mechanisms: (1) severe stenosis producing hypoperfusion, (2) embolization, (3) thrombosis, (4) dissection, 37 or (5) aneurysm rupture. 15 Other arterial beds.…”

Section: Clinical Presentation and Natural Historymentioning

confidence: 99%

Diagnosis, management, and future developments of fibromuscular dysplasia

Olin

Sealove

2011

Journal of Vascular Surgery

230

183

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Fibromuscular dysplasia (FMD) is a nonatherosclerotic noninflammatory vascular disease that primarily affects women from age 20 to 60, but may also occur in infants and children, men, and the elderly. It most commonly affects the renal and carotid arteries but has been observed in almost every artery in the body. FMD has been considered rare and thus is often underdiagnosed and poorly understood by many health care providers. There are, however, data to suggest that FMD is much more common than previously thought, perhaps affecting as many as 4% of adult women. When it affects the renal arteries, the most common presentation is hypertension. When it affects the carotid or vertebral arteries, the patient may present with transient ischemic attack or stroke, or dissection. An increasing number of patients are asymptomatic and are only discovered incidentally when imaging is performed for some other reason or by the detection of an asymptomatic bruit. FMD should be considered in the differential diagnosis of a young person with a cervical bruit; a "swishing" sound in the ear(s); transient ischemic attack, stroke, or dissection of an artery; or in individuals aged ≤ 35 years with onset hypertension. Treatment consists of antiplatelet therapy for asymptomatic individuals and percutaneous balloon angioplasty for patients with indications for intervention. Patients with aneurysms should be treated with a covered stent or open surgical repair. Little new information has been published about FMD in the last 40 years. The recently instituted International Registry for Fibromuscular Dysplasia will remedy that situation and provide observational data on a large numbers of patients with FMD.

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“…However, even at younger ages, atherosclerosis may be a major precursor of CVD, as suggested by the finding at autopsy of fibrous plaques in the carotid arteries already visible at age 20. In the present studies of young patients with CVD in Stockholm 33 " 41 a useful reference group is obtained by arbitrarily including the age group 40-55, enabling a further evaluation of etiological characteristics.…”

mentioning

confidence: 99%

Epidemiology of acute cerebrovascular disease before the age of 55 in the Stockholm County 1973-77: I. Incidence and mortality rates.

Mettinger¹,

Söderström²,

Allander³

1984

Stroke

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SUMMARYThe incidence and mortality rates of cerebrovascular disease (CVD) before age 55 were estimated for the Stockholm county between 1973 and 1977 using community based diagnosis and death statistics registers. Annual validation procedures concluded that less than 5% of hospitalized patients may have escaped registration. During the study period a diagnosis of CVD (initial stroke or TIA) was reported in 2,103 individuals, giving annual average crude incidence rates for stroke and TIA of 34 and 4 respectively per 100,000 inhabitants under age 55. Hemorrhagic lesions were reported in 45.4% of the cases, ischemic lesions in 33.1 % and unclassified lesions in 21.5%. For all diagnostic categories a strong correlation to age is found, and for most categories the male:female ratio is high. The mortality rates are high for hemorrhagic lesions and low for ischemic and unclassified lesions. Incidence rates are higher than in Uppsala and Gothenburg, Sweden, but lower than In North Karelia, Finland. Mortality rates are similar to those reported by most other investigators.

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Pathogenetic profile of TIA before 55

Cited by 21 publications

References 19 publications

The United States Registry for Fibromuscular Dysplasia

The United States Registry for Fibromuscular Dysplasia

Diagnosis, management, and future developments of fibromuscular dysplasia

Epidemiology of acute cerebrovascular disease before the age of 55 in the Stockholm County 1973-77: I. Incidence and mortality rates.

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