Background
Until now, intracranial atherosclerosis has been less well studied because of its
rarity. We sought to investigate the prevalence and risk factors of intracranial atherosclerosis
in Chinese young adult stroke patients.
Methods
We retrospectively reviewed the medical records of consecutive young adult patients
with first-ever ischemic stroke at our institution from May 2007 to May 2012. The
demographic features and risk factors of intracranial large-artery atherosclerotic
(LAA) stroke were analyzed by comparison with other stroke subtypes.
Results
One hundred ninety-seven patients (age 39 ± 9 years, 127 male) were recruited. There
were 81 (41%) patients with LAA stroke, including 68 (35%) strokes because of intracranial
stenosis. Male gender (P = .001), dyslipidemia (P = .015), smoking (P < .001), hypertension (P < .001), hyperhomocysteinemia (P = .003), and family history of stroke (P = .024) were more common in patients with intracranial LAA stroke than with non-LAA
stroke. A high percentage of patients with intracranial LAA stroke had multiple modifiable
risk factors (ie, at least 2 of dyslipidemia, hypertension, diabetes mellitus, smoking,
and hyperhomocysteinemia), much more than the patients with non-LAA stroke (82% versus
42%, P < .001). Simultaneous multiple modifiable risk factor exposure was the strongest
“risk factor” for intracranial LAA stroke, with the adjusted odds ratio of 4.99.
Conclusions
Intracranial atherosclerosis is highly prevalent in Chinese young stroke patients.
Our results suggest that simultaneous exposure to multiple risk factors may contribute
to the early development of intracranial atherosclerosis.
Key Words
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References
- Trends in stroke hospitalizations and associated risk factors among children and young adults, 1995-2008.Ann Neurol. 2011; 70: 713-721
- Clinical outcome in 287 consecutive young adults (15 to 45 years) with ischemic stroke.Neurology. 2002; 59: 26-33
- Cerebral infarction in young adults: the Baltimore-Washington Cooperative Young Stroke Study.Neurology. 1998; 50: 890-894
- Epidemiology and etiology of ischemic stroke in young adults aged 18 to 44 years in northern Sweden.Stroke. 1997; 28: 1702-1709
- Causes of ischemic stroke in young adults, and evolution of the etiological diagnosis over the long term.Eur Neurol. 2007; 57: 212-218
- Etiologic study of young ischemic stroke in Taiwan.Stroke. 2002; 33: 1950-1955
- Ischaemic stroke in young adults: predictors of outcome and recurrence.J Neurol Neurosurg Psychiatry. 2005; 76: 191-195
- A case series of young stroke in Rome.Eur J Neurol. 2006; 13: 146-152
- Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry.Stroke. 2009; 40: 1195-1203
- Race, sex and occlusive cerebrovascular disease: a review.Stroke. 1986; 17: 648-655
- Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier.Stroke. 2008; 39: 2396-2399
- Intracranial stenosis in Chinese patients with acute stroke.Neurology. 1998; 50: 812-813
- Vascular lesions in Chinese patients with transient ischemic attacks.Neurology. 1997; 48: 524-525
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke. 1993; 24: 35-41
- Intracranial arterial wall imaging using high-resolution 3-tesla contrast-enhanced MRI.Neurology. 2009; 72: 627-634
- In vivo middle cerebral artery plaque imaging by high-resolution MRI.Neurology. 2006; 67: 327-329
- In vivo high-resolution MR imaging of symptomatic and asymptomatic middle cerebral artery atherosclerotic stenosis.Atherosclerosis. 2010; 212: 507-511
- Risk factors study of ischemic stroke in young adults in Southwest China.Sichuan Da Xue Xue Bao Yi Xue Ban. 2012; 43: 553-557
- Prevalence of asymptomatic intracranial atherosclerosis in high-risk patients.Neurology. 2007; 68: 2035-2038
- The Barcelona-Asymptomatic Intracranial Atherosclerosis (AsIA) study: prevalence and risk factors.Atherosclerosis. 2012; 221: 221-225
- Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators.Stroke. 1993; 24: 1297-1304
- Ischemic stroke subtype incidence among whites, blacks, and Hispanics: the Northern Manhattan Study.Circulation. 2005; 111: 1327-1331
Article info
Publication history
Published online: March 03, 2014
Accepted:
December 18,
2013
Received in revised form:
December 3,
2013
Received:
November 21,
2013
Footnotes
Dr Wei-Hai Xu was supported by Program for New Century Excellent Talents in University of China (NCET-12-0069).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2013.12.030
Copyright
© 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.
