Subclinical Vascular Brain Lesions in Young Adults With Acute Ischemic Stroke

Giuli, Valeria De; Grassi, Mario; Besana, Michele; Zedde, Marialuisa; Zini, Andrea; Lodigiani, Corrado; Marcheselli, Simona; Cavallini, Anna; Micieli, Giuseppe; Rasura, Maurizia; DeLodovici, Maria Luisa; Tomelleri, Giampaolo; Checcarelli, Nicoletta; Chiti, Alberto; Giorli, Elisa; Sette, Massimo Del; Tancredi, Lucia; Toriello, Antonella; Braga, Massimiliano; Morotti, Andrea; Pezzini, Debora; Locatelli, Martina; Mazzoleni, Valentina; Bonacina, Sonia; Gamba, Massimo; Magoni, Mauro; Patella, Rosalba; Spalloni, Alessandra; Simone, Anna Maria; Pascarella, Rosario; Beretta, Sandro; Padovani, Alessandro; Gasparotti, Roberto; Pezzini, Alessandro

doi:10.1161/strokeaha.121.036038

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…CSVD contributes to significant morbidity and mortality through its impact on stroke risk, cognitive decline, and dementia. Small vessel disease accounts for approximately 22% of ischemic stroke, and small vessel disease burden increases the risk of recurrent stroke following ischemic or hemorrhagic stroke 1-4 . CSVD manifests as “silent” brain infarcts as well as clinically recognized small vessel ischemic strokes.…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Diagnosis and Management of Cerebral Small Vessel Disease

Sharrief¹

2023

CONTINUUM: Lifelong Learning in Neurology

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OBJECTIVECerebral small vessel disease (CSVD) is a common neurologic condition that contributes to considerable mortality and disability because of its impact on ischemic and hemorrhagic stroke risk and dementia. While attributes of the disease have been recognized for over two centuries, gaps in knowledge remain related to its prevention and management. The purpose of this review is to provide an overview of the current state of knowledge for CSVD.LATEST DEVELOPMENTSCSVD can be recognized by well-defined radiographic criteria, but the pathogenic mechanism behind the disease is unclear. Hypertension control remains the best-known strategy for stroke prevention in patients with CSVD, and recent guidelines provide a long-term blood pressure target of less than 130/80 mm Hg for patients with ischemic and hemorrhagic stroke, including those with stroke related to CSVD. Cerebral amyloid angiopathy is the second leading cause of intracerebral hemorrhage and may be increasingly recognized because of newer, more sensitive imaging modalities. Transient focal neurologic episodes is a relatively new term used to describe “amyloid spells.” Guidance on distinguishing these events from seizures and transient ischemic attacks has been published.ESSENTIAL POINTSCSVD is prevalent and will likely be encountered by all neurologists in clinical practice. It is important for neurologists to be able to recognize CSVD, both radiographically and clinically, and to counsel patients on the prevention of disease progression. Blood pressure control is especially relevant, and strategies are needed to improve blood pressure control for primary and secondary stroke prevention in patients with CSVD.

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Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Diagnosis and Management of Cerebral Small Vessel Disease

Sharrief¹

2023

CONTINUUM: Lifelong Learning in Neurology

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“…Etiology and risk factors [45,80,82,98,[104][105][106][107][108][109][110][111][112][113][114][115][116][117] FHS was consistently associated with small vessel disease [80,82,[104][105][106][107][108] and large vessel disease [80,98,[105][106][107][108], but not with cardioembolic etiology [45,116,117].…”

Section: Parameter Publications Correlationmentioning

confidence: 99%

“…With regards to stroke etiology, authors consistently reported an association of FHS with small vessel disease [80,82,[104][105][106][107][108], subclinical lacunes [109,110], intracranial artery stenosis [111][112][113][114][115] and large vessel disease [80,98,[105][106][107][108], but not with cardioembolic stroke [45,116,117]. One paper found that FHS was related to lacunar stroke in older subjects and cryptogenic etiology in the younger [118].…”

Section: Type Of Stroke Etiology and Interaction With Risk Factorsmentioning

confidence: 99%

Family history of stroke – a useful clue for the primary care physician and stroke neurologist: a narrative review

Błaż¹,

Sarzyńska‐Długosz²

2023

ppn

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Purpose:The heritability of ischemic stroke is a complex mechanism, involving the contribution of genetic traits and environmental factors, which is why in everyday practice clinicians often rely on the broad term "family history of stroke", defined as the case of any first-degree relative who has had a stroke. The aim of this review is to update the available data regarding family history of stroke in primary and secondary stroke prevention by searching the electronic Scopus database for the phrase TITLE-ABS-KEY ("family history" AND "stroke"). Views: A total of 140 articles met the pre-specified criteria and were included in the review. The prevalence of family history of stroke ranged from 37% in stroke-free individuals to 52% in patients with ischemic stroke. In primary prevention, family history of stroke was associated with increased risk of stroke, transient ischemic attack, stroke risk factors and stroke-like symptoms. In patients with ischemic stroke, it was more often associated with small-and large-vessel disease, though not with a cardioembolic etiology. Family history of stroke did not influence long-term functional outcomes after rehabilitation. In young stroke victims, it was related to symptom severity and the risk of a second stroke. Conclusions: Consideration of family history of stroke in everyday practice may carry useful information both for primary care physicians and stroke neurologists.

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“…The inflammation and immune response theory elucidates the mechanism of the immune system’s mechanism in response to harmful stimuli like damaged cells, pathogens, toxic compounds, or irradiations [ 9 ]. The vascular theory suggests a sudden interruption of blood circulation to parts of the brain, encompassing both ischemic and hemorrhagic stroke [ 10 , 11 ]. In Ischemic stroke, when the blood supply to parts of the brain is interrupted, the theory implies that stroke can occur due to blockages caused by factors affecting atherosclerosis, thrombosis, embolism, or blood clotting.…”

Section: Introductionmentioning

confidence: 99%

Examining the influence of global smoking prevalence on stroke mortality: insights from 27 countries across income strata

Abeysekera,

De Silva,

Silva

et al. 2024

BMC Public Health

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Background This study investigates the influence of Global Smoking Prevalence (GSP) on Stroke Death Rates (SDR) across 27 countries categorized into High-Income Countries (HIC), Upper Middle-Income Countries (UMIC), Lower Middle-Income Countries (LMIC), and Low-Income Countries (LIC). Methods Analysing data from two distinct periods (1990–1999 and 2010–2019), countries exhibiting an increased SDR were selected. The study uses a polynomial regression model, treating income groups as cross-sectional and years as time series data. Results Results from the regression model reveal that 17 countries observed a significant impact of GSP on SDR, with only Turkey, Solomon Islands, and Timor-Leste resulting in negative values. However, the study emphasises that out of all 27 countries, the highest occurrence of the impact of GSP on SDR has been reported in the LMIC stratum for the period under review. Conclusion It is evident that GSP affects the risk of incidence of stroke death, specifically in the LMIC stratum. Furthermore, it has been identified that GSP is a major preventable risk factor affecting global mortality. To mitigate the risk of stroke death attributable to smoking prevalence, necessary preventive steps should be adopted to encourage smoking cessation, and essential policies should be implemented to reduce the burden of SDR.

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Subclinical Vascular Brain Lesions in Young Adults With Acute Ischemic Stroke

Cited by 6 publications

References 28 publications

Diagnosis and Management of Cerebral Small Vessel Disease

Diagnosis and Management of Cerebral Small Vessel Disease

Family history of stroke – a useful clue for the primary care physician and stroke neurologist: a narrative review

Examining the influence of global smoking prevalence on stroke mortality: insights from 27 countries across income strata

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