Affiliation:
1. Neurology Department, Democritus University of Thrace, 68100 Alexandroupolis, Greece
2. Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece
Abstract
Stroke is the leading cause of functional disability worldwide, with increasing prevalence in adults. Given the considerable negative impact on patients’ quality of life and the financial burden on their families and society, it is essential to provide stroke survivors with a timely and reliable prognosis of stroke recurrence. Leukoaraiosis (LA) is a common neuroimaging feature of cerebral small-vessel disease. By researching the literature of two different databases (MEDLINE and Scopus), the present study aims to review all relevant studies from the last decade, dealing with the clinical utility of pre-existing LA as a prognostic factor for stroke recurrence in stroke survivors. Nineteen full-text articles published in English were identified and included in the present review, with data collected from a total of 34,546 stroke patients. A higher rate of extended LA was strongly associated with stroke recurrence in all stroke subtypes, even after adjustment for clinical risk factors. In particular, patients with ischemic stroke or transient ischemic attack with advanced LA had a significantly higher risk of future ischemic stroke, whereas patients with previous intracerebral hemorrhage and severe LA had a more than 2.5-fold increased risk of recurrent ischemic stroke and a more than 30-fold increased risk of hemorrhagic stroke. Finally, in patients receiving anticoagulant treatment for AF, the presence of LA was associated with an increased risk of recurrent ischemic stroke and intracranial hemorrhage. Because of this valuable predictive information, evaluating LA could significantly expand our knowledge of stroke patients and thereby improve overall stroke care.
Funder
Study of the interrelationships between neuroimaging, neurophysiological and biomechanical biomarkers in stroke rehabilitation
Competitiveness, Entrepreneurship and Innovation
Greece and the European Union
Reference55 articles.
1. Global Burden of Cardiovascular Diseases and Risk Factors, 1990–2019: Update From the GBD 2019 Study;Roth;J. Am. Coll. Cardiol.,2020
2. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association;Benjamin;Circulation,2018
3. Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019;Feigin;Lancet Neurol.,2021
4. Recovery from stroke: Current concepts and future perspectives;Grefkes;Neurol. Res. Pr.,2020
5. United Nations DoEaSA Population Division (2007). World Population Prospects, The 2006 Revision, Highlights, United Nations.