Acute Cerebrovascular Disease in the Young
Arndt Rolfs(University of Rostock), Franz Fazekas(Medical University of Graz), Ulrike Grittner(University of Rostock), Martin Dichgans(University of Rostock), Peter Martus(University of Rostock), Martin Holzhausen(University of Rostock), Tobias Böttcher(University of Rostock), Peter U. Heuschmann(University of Rostock), Turgut Tatlisumak(Finland University), Christian Tanislav(Giessen School of Theology), Gerhard J. Jungehülsing(University of Rostock), Anne‐Katrin Giese(University of Rostock), J Putaala(Finland University), Roman Huber(Universität Ulm), Ulf Bodechtel(University of Rostock), Christoph Lichy(Heidelberg University), Christian Enzinger(Medical University of Graz), Reinhold Schmidt(Medical University of Graz), Michael G. Hennerici(University of Rostock), Manfred Kaps(Giessen School of Theology), Christof Kessler(Universitätsmedizin Greifswald), Karl J. Lackner(University of Rostock), Eduard Paschke(University of Rostock), Wolfgang Meyer(Moscow Research and Clinical Center for Neuropsychiatry), Hermann Mascher(University of Rostock), Olaf Rieß(University of Rostock), Edwin H. Kolodny(University of Rostock), Bo Norrving(University of Rostock), A. Rolfs(University of Rostock), Mindy Ginsberg, MG Hennerici, Christof Kessler(Universitätsmedizin Greifswald), Edwin H. Kolodny(University of Rostock), Peter Martus(University of Rostock), Bo Norrving(University of Rostock), Ringelstein Eb(University of Münster), P M Rothwell(Science Oxford), G.S. Venables(The Stables), Natan M. Bornstein, PP DeDeyn(University of Antwerp), Martin Dichgans(Leibniz-Institute for Food Systems Biology at the Technical University of Munich), Franz Fazekas(Medical University of Graz), Hugh S. Markus, Olaf Rieß, Carla Biedermann(University of Rostock), Tobias Böttcher(University of Rostock), K. Brüderlein(University of Rostock), Jason Burmeister(University of Rostock), I Federow(University of Rostock), Franz König(University of Rostock), G Makowei(University of Rostock), David Niemann(University of Rostock), A. Rolfs(University of Rostock), Stuart Rosner(University of Rostock), Susanne Zielke(University of Rostock), Ulrike Grittner(University of Rostock), Peter Martus(University of Rostock), Martin Holzhausen(University of Rostock), Franz Fazekas(Medical University of Graz), Christian Enzinger(Medical University of Graz), Reinhold Schmidt(Medical University of Graz), Stefan Ropele(Medical University of Graz), Manfred Windisch, Eila Sterner, Olaf A. Bodamer, Andreas Fellgiebel(University of Applied Sciences Mainz), Uwe Hillen, Lisa Jonas(University of Rostock), C. Kampmann(University of Applied Sciences Mainz), Peter Kropp, Karl J. Lackner(University of Rostock), Michael Laue(University of Rostock), Hermann Mascher(University of Rostock), Wolfgang Meyer(Moscow Research and Clinical Center for Neuropsychiatry), Eduard Paschke(University of Rostock), Frank Weidemann, Jörg Berrouschot, Anett Stoll(Klinikum Altenburger Land), A Rokicha(Klinikum Altenburger Land), C Sternitzky(Klinikum Altenburger Land), Mathis Thoma, PP DeDeyn(University of Antwerp), Rishi Sheorajpanday(University of Antwerp), Isabel De Brabander(University of Antwerp), Laetitia Yperzeele(University of Antwerp), Raf Brouns(University of Antwerp), Patrick Oschmann, M. Pott, Kathrin Schultes, Cornelia Schultze, J Hirsekorn, GJ Jungehülsing(University of Rostock), Arno Villringer(Charité - Universitätsmedizin Berlin), W. U. Schmidt(Charité - Universitätsmedizin Berlin), Thomas Liman(Charité - Universitätsmedizin Berlin), Tim Nowe(Charité - Universitätsmedizin Berlin), Martin Ebinger(Charité - Universitätsmedizin Berlin), Andreas Wille(Charité - Universitätsmedizin Berlin), HOLLYANN LOUI(Charité - Universitätsmedizin Berlin), A Objartel(Charité - Universitätsmedizin Berlin), Anett Übelacker(Charité - Universitätsmedizin Berlin), Ramona Mette(Charité - Universitätsmedizin Berlin), Kati Jegzentis(Charité - Universitätsmedizin Berlin), Nabavi Dg, Olaf Crome, Debra Bahr, Markus Ebke, B Platte(Hasso Plattner Institute), C Kleinen(Kleinwächter (Germany)), Kai Günther, W. Heide(Institute of Pathology Celle), Oliver Pape(Institute of Pathology Celle), JR Hanssen(Institute of Pathology Celle), D Stangenberg(Institute of Pathology Celle), J. Klingelhöfer, Birgitte J. Schmidt(Schmid (Germany)), S. Schwarz(Rohde & Schwarz (Germany)), Julia Katharina Schwarze(Rohde & Schwarz (Germany)), L Frandlih, J Iwanow, Ingo Steinbach, Derk Krieger, G Boysen, L Leth Jeppesen, A Petersen, Heinz Reichmann(Technische Universität Dresden), Ulrik Becker(Becker Technologies (Germany)), I Dzialkowski(Technische Universität Dresden), H. Hentschel(Technische Universität Dresden), C Lautenschläger(Technische Universität Dresden), H Hanso(Hanseatic University Rostock), Georg Gahn(Technische Universität Dresden), Tjalf Ziemssen(Technische Universität Dresden), Kirk J. Fleischer(Technische Universität Dresden), B Sehr(Technische Universität Dresden), DJH McCabe, W. Oliver Tobin, J. A. Kinsella, RP Murphy, Sebastian Jander(Hochschule Düsseldorf University of Applied Sciences), HP Hartung(Hochschule Düsseldorf University of Applied Sciences), M. Siebler(Hochschule Düsseldorf University of Applied Sciences), C Bottcher(Hochschule Düsseldorf University of Applied Sciences), Angelika Köhne(Hochschule Düsseldorf University of Applied Sciences), Jens Platzen(Hochschule Düsseldorf University of Applied Sciences), TC Brosig(Hochschule Düsseldorf University of Applied Sciences), Veit Rothhammer(Roth and Rau (Germany)), C Henseler(Hochschule Düsseldorf University of Applied Sciences), Tobias Neumann‐Haefelin(Goethe University Frankfurt), OC Singer(Goethe University Frankfurt), Ummehan Ermis(Goethe University Frankfurt), IMRM dos Santos(Goethe University Frankfurt), Christoph Schuhmann(Goethe University Frankfurt), Samantha Loo(Goethe University Frankfurt), Manfred Kaps(Giessen School of Theology), Jens Allendörfer(Giessen School of Theology), Christian Tanislav(Giessen School of Theology), M Feucht S Brandtner(Giessen School of Theology), Keith W. Muir(University of Glasgow), Krishna Dani(University of Glasgow), Niall MacDougall(University of Glasgow), W. S. Smith(Adam Smith Institute), Anthony Rowe(University of Glasgow), Angela Welch(University of Glasgow), Franz Fazekas(Medical University of Graz), G. Schrotter(Medical University of Graz), U Krenn(Medical University of Graz), Susanna Horner(Medical University of Graz), B Pendl(Medical University of Graz), Aga Pluta-Fuerst(Medical University of Graz), U. Trummer(Medical University of Graz), Christof Kessler(Universitätsmedizin Greifswald), Marios Chatzopoulos(Universitätsmedizin Greifswald), Bettina von Sarnowski(Universitätsmedizin Greifswald), Ulf Schminke(Universitätsmedizin Greifswald), Thomas W. Link(Universitätsmedizin Greifswald), Alexander V. Khaw(Universitätsmedizin Greifswald), E Nieber(Universitätsmedizin Greifswald), S. Zierz, Thomas Müller, Nina Wegener, K Wartenberg, Charly Gaul, Dimitrios Richter, Michael Rosenkranz(Universität Hamburg), AC Krützelmann(Universität Hamburg), J Hoppe(Universität Hamburg), CU Choe(Universität Hamburg), S Narr(Universität Hamburg), TU Magnus(Universität Hamburg), Götz Thomalla(Universität Hamburg), Frank Leypoldt(Universität Hamburg), D Otto(Universität Hamburg), Christoph Lichy(Heidelberg University), Werner Hacke(Heidelberg University), RJ Barrows(Heidelberg University), Turgut Tatlisumak(University of Helsinki), J Putaala(University of Helsinki), Sami Curtze(Finland University), Martti Metso(Metso (Finland)), Johann Willeit(Universität Innsbruck), Martin Furtner(Universität Innsbruck), Michael Spiegel(Universität Innsbruck), Michael Knoflach(Universität Innsbruck), Barbara Prantl(Universität Innsbruck), OW Witte(Jena University Hospital), Dirk Brämer(Jena University Hospital), A Günther(Jena University Hospital), Tino Prell(Jena University Hospital), C Herzau(Jena University Hospital), Konstanze Aurich(Jena University Hospital), Günther Deuschl(Christian-Albrechts-Universität zu Kiel), Fritz Wodarg(Christian-Albrechts-Universität zu Kiel), Philip Zimmermann(Christian-Albrechts-Universität zu Kiel), Christoph Eschenfelder(Christian-Albrechts-Universität zu Kiel), Mark J. Levsen(Christian-Albrechts-Universität zu Kiel), JR Weber(University of Klagenfurt), SM Marecek(University of Klagenfurt), Dietmar Schneider(Leipzig University), Dominik Michalski(Leipzig University), Wolfgang Kloppig(Leipzig University), Lea Küppers-Tiedt(Leipzig University), M Schneider(Leipzig University), Angela Schulz(Leipzig University), Peter Matzen(Leipzig University), Christopher M. Weise(Leipzig University), Carsten Hobohm(Leipzig University), Helen C.S. Meier(Leipzig University), Reinhard Langos(Leipzig University), Daniela Urban(Leipzig University), Ilja Gerhardt(Leipzig University), Vincent Thijs(KU Leuven), Robin Lemmens(KU Leuven), Evelyn Marcelis(KU Leuven), C Hulsbosch(KU Leuven), F. Aichner(University of Arts and Industrial Design Linz), H.‐P. Haring(University of Arts and Industrial Design Linz), E Bach(University of Arts and Industrial Design Linz), J Machado Candido, AA e Silva, Michele Ramos Lourenço(Museu da Lourinhã), AIM de Sousa, Laurent Derex(Université de Lyon), Cho Th(Université de Lyon), Exuperio Díez‐Tejedor, Blanca Fuentes, Patricia Martínez‐Sánchez, MI Pérez-Guevara, Hajo M. Hamer(Philipps University of Marburg), Allan K. Metz(Philipps University of Marburg), K Hallenberger(Philipps University of Marburg), Philippe Müller(Philipps University of Marburg), Pierluigi Baron(University of Milan), Anna Bersano(University of Milan), Maria Paola Gattinoni(University of Milan), Norbert Vella(University of Malta), Marilyn Mallia(University of Malta), M. Jauß(Nordhausen University of Applied Sciences), Luise Adam(Nordhausen University of Applied Sciences), F. Heidler(Nordhausen University of Applied Sciences), C. Gube(Nordhausen University of Applied Sciences), M Kiszka(Nordhausen University of Applied Sciences), Martin Dichgans(Leibniz-Institute for Food Systems Biology at the Technical University of Munich), Anna Karpińska, Yvonne Mewald, Volker Straub(Stadtwerke Straubing (Germany)), A Dörr, A Zollver, Ringelstein Eb(University of Münster), M. Schilling(University of Münster), Alex Borchert(University of Münster), N Preuth(University of Münster), Thomas Duning(University of Münster), Gregor Kuhlenbäumer(University of Münster), D Schulte(University of Münster), P M Rothwell(Science Oxford), Lars Marquardt(Science Oxford), Felix Schlachetzki(University of Regensburg), Sandra Boy(University of Regensburg), James E. Madl(University of Regensburg), GM Ertl(University of Regensburg), N.P. Fehm(University of Regensburg), Christian Stadler(University of Regensburg), R. Benecke(University of Rostock), Aleš Dudešek(University of Rostock), Stephan Kolbaske(University of Rostock), G Lardurner(University of Salzburg), Christopher Sulzer(University of Salzburg), Alexander Zerbs(University of Salzburg), Stefan Lilek(University of Salzburg), AM Walleczek(University of Salzburg), D Sinadinowska(University of Salzburg), Marina Janelidze, Maya Beridze, N. Lobjanidze, Anna Dzagnidze, Arthur Melms(University of Tübingen), Karl Horber(University of Tübingen), I Fink(University of Tübingen), Benjamin Liske(University of Tübingen), AC Ludolph(Universität Ulm), Roman Huber(Universität Ulm), K. Knauer(Universität Ulm), Corinna Hendrich(Universität Ulm), S. Raubold(Universität Ulm), Anna Członkowska(University of Warsaw), Anna Baranowska(University of Warsaw), B Blazejewska-Hyzorek(University of Warsaw), Wilfried Lang(Hochschule Campus Wien), Wolfgang Kristoferitsch(Hochschule Campus Wien), Julia Ferrari(Hochschule Campus Wien), Elizabeth Ulrich(Hochschule Campus Wien), Agathe Flamm-Horak(Hochschule Campus Wien), Agnes Lischka-Lindner(Hochschule Campus Wien), Wolfgang Schreiber(Hochschule Campus Wien), Vida Demarin(University of Zagreb), Z Tranjec(University of Zagreb), M Bosner-Puretic(University of Zagreb), MJ Jurašić(University of Zagreb), Vanja Bašić Kes(University of Zagreb), Mislav Budišić(University of Zagreb), Lenka Kopačević(University of Zagreb)
Cited by 212Open Access
Abstract
BACKGROUND AND PURPOSE: Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients. METHODS: Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396), hemorrhagic stroke (271), transient ischemic attack (1071) were enrolled in 15 European countries and 47 centers between April 2007 and January 2010 undergoing a detailed, standardized, clinical, laboratory, and radiological protocol. RESULTS: Median age in the overall cohort was 46 years. Definite Fabry disease was diagnosed in 0.5% (95% confidence interval, 0.4%-0.8%; n=27) of all patients; and probable Fabry disease in additional 18 patients. Males dominated the study population (2962/59%) whereas females outnumbered men (65.3%) among the youngest patients (18-24 years). About 80.5% of the patients had a first stroke. Silent infarcts on magnetic resonance imaging were seen in 20% of patients with a first-ever stroke, and in 11.4% of patients with transient ischemic attack and no history of a previous cerebrovascular event. The most common causes of ischemic stroke were large artery atherosclerosis (18.6%) and dissection (9.9%). CONCLUSIONS: Definite Fabry disease occurs in 0.5% and probable Fabry disease in further 0.4% of young stroke patients. Silent infarcts, white matter intensities, and classical risk factors were highly prevalent, emphasizing the need for new early preventive strategies. Clinical Trial Registration Information- URL: http://www.clinicaltrials.gov.Unique identifier: NCT00414583.
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