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Distribution and outcome of symptomatic stenoses and occlusions in patients with acute cerebral ischemia.
Arch Neurol. 2006 Sep; 63(9):1287-91.AN

Abstract

OBJECTIVE

To describe the distribution of steno-occlusive disease and the associated rate of recurrence in patients with acute cerebral ischemia.

DESIGN

An inception cohort was prospectively recruited after an index event and followed up to assess recurrent stroke and death up to 1 year after the event.

SETTING

Eleven German departments of neurology with acute stroke units.

PATIENTS

A total of 4157 patients who experienced an acute ischemic stroke or a transient ischemic attack and had complete cerebrovascular examination results. Follow-up information could be obtained in 85.3% of these patients.

RESULTS

Symptomatic vessel occlusions were associated with a high mortality rate and were found most often in the proximal internal carotid artery (6.5% of patients), the M1 segment of the middle cerebral artery (3.7%), and the vertebral artery (3.0%). Symptomatic stenosis of 50% to 99% of the internal carotid artery was found in 308 patients (7.4%), and 272 patients (6.5%) had symptomatic intracranial stenosis. The highest rates of recurrent stroke during the first 3 days occurred in patients with symptomatic carotid and intracranial occlusions. Overall, 82 (8.0%) of 1027 patients with symptomatic cerebrovascular disease experienced a recurrent stroke between day 4 and 1 year, but no significant differences in recurrent stroke rates could be found when comparing different locations of steno-occlusive disease.

CONCLUSIONS

Our study provides representative data on the distribution and outcome of steno-occlusive disease in patients with acute cerebral ischemia. In contrast to prior studies in more selected populations, the rate of recurrent stroke in patients with symptomatic intracranial stenosis was not elevated compared with that of patients without steno-occlusive disease.

Authors+Show Affiliations

Departments of Neurology, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. stroke.med@uni-essen.deNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16966507

Citation

Weimar, Christian, et al. "Distribution and Outcome of Symptomatic Stenoses and Occlusions in Patients With Acute Cerebral Ischemia." Archives of Neurology, vol. 63, no. 9, 2006, pp. 1287-91.
Weimar C, Goertler M, Harms L, et al. Distribution and outcome of symptomatic stenoses and occlusions in patients with acute cerebral ischemia. Arch Neurol. 2006;63(9):1287-91.
Weimar, C., Goertler, M., Harms, L., & Diener, H. C. (2006). Distribution and outcome of symptomatic stenoses and occlusions in patients with acute cerebral ischemia. Archives of Neurology, 63(9), 1287-91.
Weimar C, et al. Distribution and Outcome of Symptomatic Stenoses and Occlusions in Patients With Acute Cerebral Ischemia. Arch Neurol. 2006;63(9):1287-91. PubMed PMID: 16966507.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Distribution and outcome of symptomatic stenoses and occlusions in patients with acute cerebral ischemia. AU - Weimar,Christian, AU - Goertler,Michael, AU - Harms,Lutz, AU - Diener,Hans-Christoph, PY - 2006/9/13/pubmed PY - 2006/10/19/medline PY - 2006/9/13/entrez SP - 1287 EP - 91 JF - Archives of neurology JO - Arch Neurol VL - 63 IS - 9 N2 - OBJECTIVE: To describe the distribution of steno-occlusive disease and the associated rate of recurrence in patients with acute cerebral ischemia. DESIGN: An inception cohort was prospectively recruited after an index event and followed up to assess recurrent stroke and death up to 1 year after the event. SETTING: Eleven German departments of neurology with acute stroke units. PATIENTS: A total of 4157 patients who experienced an acute ischemic stroke or a transient ischemic attack and had complete cerebrovascular examination results. Follow-up information could be obtained in 85.3% of these patients. RESULTS: Symptomatic vessel occlusions were associated with a high mortality rate and were found most often in the proximal internal carotid artery (6.5% of patients), the M1 segment of the middle cerebral artery (3.7%), and the vertebral artery (3.0%). Symptomatic stenosis of 50% to 99% of the internal carotid artery was found in 308 patients (7.4%), and 272 patients (6.5%) had symptomatic intracranial stenosis. The highest rates of recurrent stroke during the first 3 days occurred in patients with symptomatic carotid and intracranial occlusions. Overall, 82 (8.0%) of 1027 patients with symptomatic cerebrovascular disease experienced a recurrent stroke between day 4 and 1 year, but no significant differences in recurrent stroke rates could be found when comparing different locations of steno-occlusive disease. CONCLUSIONS: Our study provides representative data on the distribution and outcome of steno-occlusive disease in patients with acute cerebral ischemia. In contrast to prior studies in more selected populations, the rate of recurrent stroke in patients with symptomatic intracranial stenosis was not elevated compared with that of patients without steno-occlusive disease. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/16966507/Distribution_and_outcome_of_symptomatic_stenoses_and_occlusions_in_patients_with_acute_cerebral_ischemia_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneur.63.9.1287 DB - PRIME DP - Unbound Medicine ER -