scholarly journals Age dependency of ischaemic stroke subtypes and vascular risk factors in western Norway: the Bergen Norwegian Stroke Cooperation Study

2015 ◽  
Vol 133 (3) ◽  
pp. 202-207 ◽  
Author(s):  
A. Nacu ◽  
A. Fromm ◽  
K. M. Sand ◽  
U. Waje‐Andreassen ◽  
L. Thomassen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Vascular Risk Factors ◽  
Age Dependency ◽  
Vascular Risk ◽  
Stroke Subtypes ◽  
Western Norway

scholarly journals Prevalence of the Frank’s sign by aetiopathogenic stroke subtype: A prospective analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261080
Author(s):  
Laura Sánchez-Cirera ◽  
Saima Bashir ◽  
Adina Ciscar ◽  
Carla Marco ◽  
Verónica Cruz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Acute Stroke ◽  
Haemorrhagic Stroke ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Subtype ◽  
Cross Sectional ◽  
Stroke Subtypes ◽  
Artery Disease

Background and purpose The Frank’s sign is a diagonal earlobe crease running from the tragus to the edge of the auricle at an angle of 45°. Many studies have associated this sign with coronary artery disease and some with cerebrovascular disease. The objective of this study was to analyse the prevalence of the Frank’s sign in patients suffering from acute stroke with a particular focus on its prevalence in each of the five aetiopathogenic stroke subtypes. Special interest is given to embolic stroke of undetermined source (ESUS), correlating the sign with clinical and radiological markers that support an underlying causal profile in this subgroup. Methods Cross-sectional descriptive study including 124 patients admitted consecutively to a stroke unit after suffering an acute stroke. The Frank’s sign was evaluated by the same blinded member of the research team from photographs taken of the patients. The stroke subtype was classified following SSS-TOAST criteria and the aetiological study was performed following the ESO guidelines. Results The Frank’s sign was present in 75 patients and was more prevalent in patients with an ischaemic stroke in comparison with haemorrhagic stroke (63.9 vs. 37.5, p<0.05). A similar prevalence was found in the different ischaemic stroke subtypes. The Frank’s sign was significantly associated with age, particularly in patients older than 70 who had vascular risk factors. Atherosclerotic plaques found in carotid ultrasonography were significantly more frequent in patients with the Frank’s sign (63.6%, p<0.05). Analysing the ESUS, we also found an association with age and a higher prevalence of the Frank’s sign in patients with vascular risk factors and a tendency to a high prevalence of atherosclerosis markers. Conclusion The Frank’s sign is prevalent in all aetiopathogenic ischaemic stroke subtypes, including ESUS, where it could be helpful in suspecting the underlying cardioembolic or atherothrombotic origin and guiding the investigation of atherosclerosis in patients with ESUS and the Frank’s sign.

Hyperhomocysteinemia: Relationship to vascular risk factors and stroke subtypes

1999 ◽  
Vol 8 (4) ◽  
pp. 280
Author(s):  
Abbur Rekha ◽  
Souvik Sen ◽  
Anand Vaishnav ◽  
Mohamed Ibrahim ◽  
Piero Verro
Keyword(s):  
Risk Factors ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Subtypes

scholarly journals Association between excessive premature atrial complexes and cryptogenic stroke: results of a case–control study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029164 ◽  
Author(s):  
Jithin K Sajeev ◽  
Anoop N Koshy ◽  
Helen Dewey ◽  
Jonathan M Kalman ◽  
Kevin Rajakariar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Case Control Study ◽  
Cryptogenic Stroke ◽  
Case Control ◽  
Vascular Risk Factors ◽  
Control Group ◽  
Prior History ◽  
Vascular Risk ◽  
Control Study

ObjectiveRecent anticoagulation trials in all-comer cryptogenic stroke patients have yielded equivocal results, reinvigorating the focus on identifying reproducible markers of an atrial myopathy. We investigated the role of excessive premature atrial complexes (PACs) in ischaemic stroke, including cryptogenic stroke and its association with vascular risk factors.Methods and resultsA case–control study was conducted utilising a multicentre institutional stroke database to compare 461 patients with an ischaemic stroke or transient ischaemic attack (TIA) with a control group consisting of age matched patients without prior history of ischaemic stroke/TIA. All patients underwent 24-hour Holter monitoring during the study period and atrial fibrillation was excluded. An excessive PAC burden, defined as ≥200 PACs/24 hours, was present in 25.6% and 14.7% (p<0.01), of stroke/TIA and control patients, respectively. On multivariate regression, excessive PACs (OR 1.97; 95% CI 1.29 to 3.02; p<0.01), smoking (OR 1.58; 95% CI 1.06 to 2.36; p<0.05) and hypertension (OR 1.53; 95% CI 1.07 to 2.17; p<0.05) were independently associated with ischaemic stroke/TIA. Excessive PACs remained the strongest independent risk factor for the cryptogenic stroke subtype (OR 1.95; 95% CI 1.16 to 3.28; p<0.05). Vascular risk factors that promote atrial remodelling, increasing age (≥75 years, OR 3.64; 95% CI 2.08 to 6.36; p<0.01) and hypertension (OR 1.54; 95% CI 1.01 to 2.34; p<0.05) were independently associated with excessive PACs.ConclusionsExcessive PACs are independently associated with cryptogenic stroke and may be a reproducible marker of atrial myopathy. Prospective studies assessing their utility in guiding stroke prevention strategies may be warranted.

scholarly journals Trends in stroke subtypes and vascular risk factors in a stroke center in China over 10 years

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Danyang Tian ◽  
Qiong Yang ◽  
Quan Dong ◽  
Nan Li ◽  
Bernard Yan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Stroke Subtypes ◽  
Stroke Center

Management of vascular risk factors and co-morbidities in secondary stroke prevention

ESC CardioMed ◽  
2018 ◽  
pp. 971-975
Author(s):  
Martin O’Donnell ◽  
Cliona Small
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Risk Factor ◽  
Ischaemic Stroke ◽  
Stroke Prevention ◽  
Alcohol Intake ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Vascular Events ◽  
Lifestyle Risk

Medical approaches to reducing the risk of recurrent stroke following ischaemic stroke or transient ischaemic attack, and other major vascular events, involves a targeted modification of vascular risk factors, including lifestyle factors (e.g. physical inactivity, smoking, and diet), hypertension, and hyperlipidaemia and glycaemic control. The INTERSTROKE study reported that ten potentially modifiable vascular risk factors were associated with about 90% of the population attributable risk for stroke. Modification of lifestyle risk factors remains a cornerstone of stroke prevention, and includes promoting increased physical activity, smoking cessation, adopting healthier dietary patterns, weight reduction in those who are overweight/obese, and avoiding high alcohol intake (and heavy episode alcohol intake). All patients with blood pressure levels greater than or equal to 140/90 mmHg should be treated with antihypertensive therapy (although some suggest a lower threshold in patients with non-cardioembolic stroke), with a recent trial suggesting that patients with small vessel ischaemic stroke may benefit from lowering blood pressure to less than 130/90 mmHg. Statin therapy in patients with elevated low-density lipoprotein is associated with a reduction in major vascular events after ischaemic stroke, with a more aggressive strategy adopted in patients with ischaemic stroke due to large vessel atherosclerosis. While sleep apnoea is a risk factor for stroke, treatment with continuous positive airway pressure did not reduce the risk of stroke in a recent, large clinical trial. The optimal approach to achieve high rates of vascular risk factor targets following stroke has not been identified, but evaluations of community-based interventions are ongoing.

scholarly journals A large number of cerebral microbleeds in CADASIL patients presenting with recurrent seizures: A case report

2019 ◽  
Author(s):  
Chumpol Anamnart ◽  
Dittapong Songsaeng ◽  
Sirisak Chanprasert
Keyword(s):  
Risk Factors ◽  
Ischaemic Stroke ◽  
Acute Ischaemic Stroke ◽  
Vascular Risk Factors ◽  
Cerebral Microbleeds ◽  
Diagnostic Study ◽  
Vascular Risk ◽  
Notch3 Gene ◽  
Study Results ◽  
The Brain

Abstract Background: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary arteriopathy associated with the NOTCH3 gene. Clinical manifestations include strokes, transient ischaemic events, psychiatric disturbances, dementia, and migraines. We report a case of a Thai man with a severe CADASIL phenotype who presented with recurrent seizures and acute ischaemic stroke and classic vascular risk factors. Case presentation: A 50-year-old man with a history of mood disorder and progressive cognitive decline for 20 years as well as well-controlled diabetes mellitus and hypertension presented with recurrent generalized seizures and acute right-sided weakness. An MRI of the brain showed acute infarction of the left pons, a large number of cerebral microbleeds throughout the brain and white matter abnormalities without classic anterior temporal lobe lesions. Molecular genetic testing identified a homozygous pathologic variant, c.1672C>T (p. Arg558Cys), in the NOTCH3 gene. The diagnosis of CADASIL was confirmed. His clinical symptoms deteriorated, and he died of tracheobronchitis with secretion obstruction. Conclusion: This case raises awareness of an uncommon cause of acute ischaemic stroke in patients with classic vascular risk factors and emphasizes the need for a complete evaluation in cases with unexpected clinical presentation or unexpected diagnostic study results.

scholarly journals Stroke Epidemiology in Oceania: A Review

2021 ◽  
Vol 55 (1) ◽  
pp. 1-10
Author(s):  
Narayanaswamy Venketasubramanian
Keyword(s):  
Risk Factors ◽  
Common Factor ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Vascular Risk Factors ◽  
World Health ◽  
Vascular Risk ◽  
Stroke Subtypes ◽  
Life Years ◽  
Stroke Epidemiology

Background and Purpose: Oceania, comprising the regions Australasia, Melanesia, Micronesia, and Polynesia, is home to 42 million living in 8.5 million square kilometres of land. This paper comprises a review of the epidemiology of stroke in countries in this region. Methods: Information on epidemiology of stroke in Oceania was sought from data from the Global Burden of Disease (GBD) study (incidence, mortality, incidence:mortality ratio [IMR], prevalence, disability-adjusted life-years [DALYs] lost due to stroke, and subtypes), World Health Organization (WHO) (vascular risk factors in the community), and PubMed (incidence, prevalence, and stroke subtypes). Data were analyzed by region to allow inter-country comparison within each region. Results: In 2010, age- and sex-standardized stroke mortality rates were lowest in Australasia (29.85–31.67/100,000) and highest in Melanesia and Micronesia (56.04–187.56/100,000), with wide ranges especially in Melanesia. Incidence rates were lowest in Australasia (101.36–105.54/100,000), similarly high elsewhere. Standardized IMR (0.98–3.39) was the inverse of the mortality rates and mirrored the prevalence rates (202.91–522.29/100,000). DALY rates (398.22–3,781.78/100,0000) mirrored the mortality rates. Stroke risk factors show a variable pattern – hypertension is generally the most common medical risk factor among males (18.0–26.6%), while among females, diabetes mellitus is the most common in Micronesia and Polynesia (21.5–28.4%). Among the lifestyle factors, current smoking is the most common in Melanesia among males, while obesity is generally the most common factor among females. Ischaemic stroke comprises 70% of stroke subtypes. Trend data show significant falls in standardized mortality rates and DALYs in most regions and falls in incidence in almost all countries. There is significant economic impact, particularly due to young strokes; some ethnicities are at higher risk than others, for example, Maoris and Pacific Islanders. Conclusions: Stroke is a major healthcare problem in Oceania. Variations in stroke epidemiology are found between countries in Oceania. Data are lacking in some; more research into the burden of stroke in Oceania is needed. With the expected increase in life expectancy and vascular risk factors, the burden of stroke in Oceania will likely rise. Some of the disparities in stroke burden may be addressed by great investment in healthcare.

Sign in / Sign up

Export Citation Format

Share Document