Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Haidegger, M; Klock, N; Kneihsl, M; Fandler-Höfler, S; Eppinger, S; Eller, K; Seiler, S; Enzinger, C; Gattringer, T.
Recurrent cerebrovascular events after recent small subcortical infarction.
J Neurol. 2024; 271(8): 5055-5063.
Doi: 10.1007/s00415-024-12460-8
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- Führende Autor*innen der Med Uni Graz
- Gattringer Thomas
- Haidegger Melanie
- Co-Autor*innen der Med Uni Graz
- Eller Kathrin
- Enzinger Christian
- Eppinger Sebastian
- Fandler-Höfler Simon
- Kneihsl Markus
- Seiler Stephan
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- Abstract:
- BACKGROUND: Recent small subcortical infarcts (RSSI) are the neuroimaging hallmark feature of small vessel disease (SVD)-related acute lacunar stroke. Long-term data on recurrent cerebrovascular events including their aetiology after RSSI are scarce. PATIENTS AND METHODS: This retrospective study included all consecutive ischaemic stroke patients with an MRI-confirmed RSSI (in the supply area of a small single brain artery) at University Hospital Graz between 2008 and 2013. We investigated associations between clinical and SVD features on MRI (STRIVE criteria) and recurrent cerebrovascular events, using multivariable Cox regression adjusted for age, sex, vascular risk factors and MRI parameters. RESULTS: We analysed 332 consecutive patients (mean age 68 years, 36% women; median follow-up time 12 years). A recurrent ischaemic cerebrovascular event occurred in 70 patients (21.1%; 54 ischaemic strokes, 22 transient ischaemic attacks) and was mainly attributed to SVD (68%). 26 patients (7.8%) developed intracranial haemorrhage. In multivariable analysis, diabetes (HR 2.43, 95% CI 1.44-3.88), severe white matter hyperintensities (HR 1.97, 95% CI 1.14-3.41), and cerebral microbleeds (HR 1.89, 95% CI 1.32-3.14) on baseline MRI were related to recurrent ischaemic stroke/TIA, while presence of cerebral microbleeds increased the risk for intracranial haemorrhage (HR 3.25, 95% CI 1.39-7.59). A widely used SVD summary score indicated high risks of recurrent ischaemic (HR 1.22, 95% CI 1.01-1.49) and haemorrhagic cerebrovascular events (HR 1.57, 95% CI 1.11-2.22). CONCLUSION: Patients with RSSI have a substantial risk for recurrent cerebrovascular events-particularly those with coexisting chronic SVD features. Recurrent events are mainly related to SVD again.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Female - administration & dosage
- Male - administration & dosage
- Aged - administration & dosage
- Recurrence - administration & dosage
- Retrospective Studies - administration & dosage
- Middle Aged - administration & dosage
- Magnetic Resonance Imaging - administration & dosage
- Risk Factors - administration & dosage
- Cerebral Small Vessel Diseases - diagnostic imaging, epidemiology, complications
- Follow-Up Studies - administration & dosage
- Aged, 80 and over - administration & dosage
- Cerebral Infarction - diagnostic imaging, etiology, epidemiology
- Ischemic Stroke - diagnostic imaging, complications, etiology, epidemiology
- Find related publications in this database (Keywords)
- Cerebral small vessel disease
- Recurrent events
- Intracranial haemorrhage
- Imaging
- Recent small subcortical infarct