Ischaemic stroke in young people: A prospective and long-term follow-up study
| Autor: | N. Leggiadro, Agatino Manganaro, Santo Gangemi, Antonio Epifanio, Raoul Di Perri, G. Gallitto, Paolino La Spina, Scipione Carerj, Granata A, Fortunata Tripodi, R. Musolino |
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| Jazyk: | angličtina |
| Rok vydání: | 2003 |
| Předmět: |
Male
Pediatrics Time Factors Severity of Illness Index Brain Ischemia Disability Evaluation Recurrence Risk Factors Ischaemic stroke Epidemiology Prevalence Prospective Studies Ultrasonography Doppler Color Young adult Prospective cohort study Cerebral ischaemia Middle Aged Prognosis Management Stroke Italy Neurology Patient Satisfaction Female Cardiology and Cardiovascular Medicine Adult medicine.medical_specialty Ticlopidine Adolescent MEDLINE Patient satisfaction Fibrinolytic Agents Severity of illness medicine Humans Aspirin business.industry Acenocoumarol Anticoagulants Physical therapy Etiology Patient Compliance Neurology (clinical) Tomography X-Ray Computed business Echocardiography Transesophageal Magnetic Resonance Angiography Follow-Up Studies |
| Popis: | Background: A few studies have comprehensively assessed the epidemiology, aetiology, prognosis, and secondary prevention of ischaemic stroke in young adults. To gain further information on this field, we have prospectively studied a hospital-based series of young adults with a first-ever episode of cerebral ischaemia (CI). Methods: Sixty consecutive patients aged 17–45 with ischaemic stroke (55 patients) or transient ischaemic attack within 24 h before hospital admission were recruited and investigated by a standardized rigorous protocol. The patients were followed up for ≧1 year after hospital discharge. Arbitrary doses of aspirin 100 mg/d or ticlopidine 250 mg b.i.d. in case of intolerance to aspirin were given for the secondary prevention. Adjusted-dose oral anticoagulation (INR target 2.5) was used in the presence of cardioembolism or hypercoagulable states. Endpoints included the residual disability, rated by modified Rankin Scale (RS) and Barthel Index (BI), and poststroke recurrence. Results: CI was associated with two or more risk factors in 61.6% of patients. Cigarette smoking was more frequently associated with male gender (p < 0.05) and migraine history with female sex (p < 0.05). The atherothrombotic diagnostic subtype and the subtype from ‘other cause’ predominated significantly among patients ≧35 years old (p < 0.05) and 3) in 11% of the patients, slight to moderate (1≧RS≤3) in 59% and absent in 30% (RS = 0). Functional disability was relatively low with 50% of the patients independent (BI ≧95), 38.9% partially dependent (BI 60 to 86), and 11.1% fully dependent (BI Conclusions: The present study, though limited by the relatively small number of subjects, suggests that the overall prognosis of ischaemic stroke in young adults is good. We strongly recommend TEE in all patients with ischaemic stroke as an essential tool to increase the detection of PCSE and make the therapeutic approach more efficient. |
| Databáze: | OpenAIRE |
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