1969

DOI: 10.7326/0003-4819-70-4-807

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Nonatherosclerotic Causes of Stroke

Jonathan Levine¹,

Phillip D. Swanson

²

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1978

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Cited by 37 publications

(8 citation statements)

References 33 publications

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“…7 Cerebral emboli of cardiac origin was the most common cause of cerebral ischemia in our study, as well as in Levine and Swanson's, with more than half the patients within this group having rheumatic heart disease. The search for a cardiac embolic source is important since the value of anticoagulation in decreasing mortality and preventing recurrent embolism has been established.…”

Section: Discussionmentioning

confidence: 77%

“…Because of the relatively low prevalence of degenerative arterial disease in the young, potentially treatable non-atheromatous conditions may exist in the young adult with stroke. 7 Despite careful investigation, among young patients many cases of ischemic cerebrovascular disease emerge in which the etiology is unclear and the role of established risk factors is uncertain. 8 " 12 In order to examine these factors, the records of young adults with cerebral infarction who had been hospitalized at the Medical College of Virginia hospitals were reviewed.…”

mentioning

confidence: 99%

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Cerebral infarction in young adults.

et al. 1978

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SUMMARY The etiologic and prognostic features which characterize cerebrovascular disease in the later decades of life are not applicable in younger patients. The records of 58 patients who had suffered cerebral infarction between the ages of 15 and 40 were reviewed in order to study these features.Fifty-five percent of the patients were found to have had an identifiable etiology for their cerebral infarction, with nearly half of these suffering from embolic infarction of cardiac origin. In 45% no clear etiology could be established but hypertension was prevalent in those patients between 31 and 40 years of age. Follow up data were obtained on 68% of the hospital survivors; nearly V* of them had completely recovered or had improved.CEREBROVASCULAR DISEASE occurs predominately in the later decades of life. However, the occurrence of stroke in young adults is not an insignificant problem. The annual incidence of stroke in the 35 to 45 age group is estimated at 25 per 100,000.' Aring and Merritt, 2 in an age incidence tabulation of autopsied cases of cerebrovascular lesions, found that 5% of strokes occur in individuals under 40. It has been pointed out that this figure relates to necropsied cases, and that the actual incidence may be greater. 3Two large studies of cerebrovascular disease originating from India 4 and Ceylon 5 estimate that 27.2% and 32% respectively of all strokes occur in adults under 40. These findings may not be applicable to other world populations because of differences in culture, diet, genetics, or other unidentified factors.The etiologic and prognostic features which characterize cerebral infarction among older patients may not be applicable to young adults. Because of the relatively low prevalence of degenerative arterial disease in the young, potentially treatable non-atheromatous conditions may exist in the young adult with stroke.7 Despite careful investigation, among young patients many cases of ischemic cerebrovascular disease emerge in which the etiology is unclear and the role of established risk factors is uncertain. 8 " 12 In order to examine these factors, the records of young adults with cerebral infarction who had been hospitalized at the Medical College of Virginia hospitals were reviewed. MethodsThe Medical College of Virginia Hospital is a large urban teaching center with a population of referral as well as community care patients. The medical records of all inpatients age 15 to 40 with cerebrovascular disease admitted to the Medical College of Virginia Hospitals between August 1, 1970 and July 31, 1975 were reviewed retrospectively.Patients included in the study had suffered cerebral infarction just prior to admission or while in the hospital. Patients with hemorrhagic strokes were not included. If a patient had more than one cerebral infarct during the period of the study, only the first was included. This study was supported in part by the Student Clerkship in stroke sponsored by the American Heart Association.Patient data collected included family history, predisposi...

“…7 Cerebral emboli of cardiac origin was the most common cause of cerebral ischemia in our study, as well as in Levine and Swanson's, with more than half the patients within this group having rheumatic heart disease. The search for a cardiac embolic source is important since the value of anticoagulation in decreasing mortality and preventing recurrent embolism has been established.…”

Section: Discussionmentioning

confidence: 77%

“…Because of the relatively low prevalence of degenerative arterial disease in the young, potentially treatable non-atheromatous conditions may exist in the young adult with stroke. 7 Despite careful investigation, among young patients many cases of ischemic cerebrovascular disease emerge in which the etiology is unclear and the role of established risk factors is uncertain. 8 " 12 In order to examine these factors, the records of young adults with cerebral infarction who had been hospitalized at the Medical College of Virginia hospitals were reviewed.…”

mentioning

confidence: 99%

Cerebral infarction in young adults.

et al. 1978

View full text Add to dashboard Cite

SUMMARY The etiologic and prognostic features which characterize cerebrovascular disease in the later decades of life are not applicable in younger patients. The records of 58 patients who had suffered cerebral infarction between the ages of 15 and 40 were reviewed in order to study these features.Fifty-five percent of the patients were found to have had an identifiable etiology for their cerebral infarction, with nearly half of these suffering from embolic infarction of cardiac origin. In 45% no clear etiology could be established but hypertension was prevalent in those patients between 31 and 40 years of age. Follow up data were obtained on 68% of the hospital survivors; nearly V* of them had completely recovered or had improved.CEREBROVASCULAR DISEASE occurs predominately in the later decades of life. However, the occurrence of stroke in young adults is not an insignificant problem. The annual incidence of stroke in the 35 to 45 age group is estimated at 25 per 100,000.' Aring and Merritt, 2 in an age incidence tabulation of autopsied cases of cerebrovascular lesions, found that 5% of strokes occur in individuals under 40. It has been pointed out that this figure relates to necropsied cases, and that the actual incidence may be greater. 3Two large studies of cerebrovascular disease originating from India 4 and Ceylon 5 estimate that 27.2% and 32% respectively of all strokes occur in adults under 40. These findings may not be applicable to other world populations because of differences in culture, diet, genetics, or other unidentified factors.The etiologic and prognostic features which characterize cerebral infarction among older patients may not be applicable to young adults. Because of the relatively low prevalence of degenerative arterial disease in the young, potentially treatable non-atheromatous conditions may exist in the young adult with stroke.7 Despite careful investigation, among young patients many cases of ischemic cerebrovascular disease emerge in which the etiology is unclear and the role of established risk factors is uncertain. 8 " 12 In order to examine these factors, the records of young adults with cerebral infarction who had been hospitalized at the Medical College of Virginia hospitals were reviewed. MethodsThe Medical College of Virginia Hospital is a large urban teaching center with a population of referral as well as community care patients. The medical records of all inpatients age 15 to 40 with cerebrovascular disease admitted to the Medical College of Virginia Hospitals between August 1, 1970 and July 31, 1975 were reviewed retrospectively.Patients included in the study had suffered cerebral infarction just prior to admission or while in the hospital. Patients with hemorrhagic strokes were not included. If a patient had more than one cerebral infarct during the period of the study, only the first was included. This study was supported in part by the Student Clerkship in stroke sponsored by the American Heart Association.Patient data collected included family history, predisposi...

“…Of these patients with rapid or instantaneous onset, more than a third had noted recent transient neurological symptoms. Six patients (19%) had stepwise or gradual onset over a time range of ninety minutes 16 to four days. 8,25 Four patients with recurrent hemiplegic migraine had infarcts or prolonged persistence of neurologic deficits after headache episodes, and one individual had a permanent homonymous hemi-anopsia after a severe visual aura.…”

Section: Age (Years)mentioning

confidence: 99%

Clinical Features of Stroke in Migraine: A Review

¹

1986

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SYNOPSIS High resolution CT scanning in patients with post‐traumatic head pain is superior to conventional radiography for detecting fractures and other lesions of the facial structures. This is an important consideration, since such lesions may be responsible for the post‐traumatic pain. Direct axial and coronal scanning is adequate for diagnosis in most cases; multiplanar reconstructions can be done to obtain sagittal and other views. The radiation dose and cost of CT are comparable to those of conventional tomography.

“…Increased WBV has shown to result in vascular remodeling, impaired vascular dilatation, altered lipid metabolism, and to induce endothelial inflammation . In humans, increased WBV is associated with an increase in cardiovascular risk factors and greater atherothrombotic risk, including an increased risk of stroke and myocardial infarction …”

Section: Introductionmentioning

confidence: 99%

“…10,11 In humans, increased WBV is associated with an increase in cardiovascular risk factors and greater atherothrombotic risk, including an increased risk of stroke and myocardial infarction. [12][13][14][15][16][17][18][19] HD patients face an extremely high risk of cardiovascular events and associated mortality. Recently, large interdialytic weight gain that requires greater UF volume 20,21 has been related to adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

The effect of hemodialysis ultrafiltration on changes in whole blood viscosity

¹

,

²

,

³

et al. 2012

Hemodialysis International

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Increased whole blood viscosity (WBV) can be injurious to the vascular endothelium and increase the risk of atherothrombotic events. This study examined the effect of hemodialysis ultrafiltration (UF) on WBV, with a focus on high vs. low-volume UF patients. In stable hemodialysis patients, blood was drawn for hematocrit (Hct) and WBV at the start, midpoint, and at the end of dialysis. For analysis, patients were divided into high UF (≥2700 mL) or low UF (<2700 mL) groups. A total of 59 patients completed the study. Mean Hct increased during dialysis in both groups. The intradialytic increase in Hct was significantly greater in the high vs. the low UF group (3.2% vs. 1.28%, P = 0.01), with a significantly higher end-dialysis Hct in the high UF group (40.5% vs. 38%, P = 0.02). At the end of dialysis, both high shear rate WBV (P < 0.01) and low shear rate WBV (P < 0.01) were significantly higher in the high UF compared with the low UF group. There was an approximately two-fold greater increase in high shear rate (P < 0.01) and low shear rate (P = 0.01) WBV during dialysis in high vs. low UF groups. The increase in high shear rate WBV during dialysis was significantly correlated with an increase in Hct (R(2) = 0.63, P < 0.01). We found that hemodialysis UF causes a surge in WBV. The surge was of greater magnitude in high than in low UF patients.

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