Stroke Care in Young Patients

Author:

Tancredi L.1,Martinelli Boneschi F.2,Braga M.3,Santilli I.4,Scaccabarozzi C.5,Lattuada P.6,Sessa M.2,Fumagalli L.7,Iurlaro S.8,Neromante I.9,De Lodovici M. L.10,Roccatagliata D. V.4,Giacalone G.2,Arnaboldi M.1,Crespi V.3,Agostoni E.5,Comi G. C.2,Ferrarese C.7,Sterzi R.4

Affiliation:

1. Stroke Unit, Neurology Department, Azienda Ospedaliera Sant'Anna Hospital, Via Ravona 1, 22020 San Fermo della Battaglia, Como, Italy

2. Institute of Experimental Neurology (INSPE) and Stroke Unit, San Raffaele Scientific Institute, 20132 Milano, Italy

3. Stroke Unit, Neurology Department, Azienda Ospedaliera di Desio e Vimercate, 20871 Vimercate, Italy

4. Stroke Unit, Neurology Department, Azienda Ospedaliera Niguarda Cà Granda, 20162 Milan, Italy

5. Stroke Unit, Neurology Department, Azienda Ospedaliera A. Manzoni, 23900 Lecco, Italy

6. Stroke Unit, Neurology Department, Azienda Ospedaliera Ospedale San Carlo Borromeo, 20153 Milan, Italy

7. Stroke Unit, Neurology Department, Azienda Ospedaliera San Gerardo, 20900 Monza, Italy

8. Neurology Department, Azienda Ospedaliera di Lodi, 26900 Lodi, Italy

9. Neurology Department, Azienda Ospedaliera di Busto Arsizio, 21052 Varese, Italy

10. Neurology Department, Ospedale di Circolo e Fondazione Macchi, 21100 Varese, Italy

Abstract

The aims of this study were (i) to evaluate the clinical features of a consecutive series of young patients with ischemic stroke and (ii) to assess the changes in the clinical management of these patients over the study period. All consecutive cases of young adults aged 16 to 44 years, with ischemic stroke, that were admitted between 2000 and 2005 in 10 Italian hospitals were included. We retrospectively identified 324 patients. One or more vascular risk factors were present in 71.5% of the patients. With respect to the diagnostic process, an increase in the frequency of cerebral noninvasive angiographic studies and a decrease in the use of digital subtraction angiography were observed (P<0.001andP=0.03, resp.). Undetermined causes decreased over 5-year period of study (P<0.001). The diagnosis of cardioembolism increased. Thrombolysis was performed for 7.7% of the patients. PFO closure (8%) was the most frequently employed surgical procedure. In conclusion, the clinical care that is given to young patients with ischemic stroke changed over the study period. In particular, we detected an evolution in the diagnostic process and a reduction in the number of undetermined cases.

Publisher

Hindawi Limited

Subject

Neurology (clinical)

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