Related Experiment Videos
[Recurrent ischemic stroke. Study of 605 patients]
Adrià Arboix1, Joan Massons, Luís García-Eroles
1Unidad de Enfermedades Vasculares Cerebrales, Servicio de Neurología, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, España. aarboix@hscor.com
Summary
Approximately 22.4% of ischemic stroke patients experience recurrence. Key predictors include prior hemorrhage, hypertension, and diabetes, with higher in-hospital mortality in recurrent cases.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Epidemiology
Context:
- Ischemic stroke recurrence poses a significant clinical challenge.
- Understanding recurrence patterns is crucial for patient management and secondary prevention strategies.
Purpose:
- To characterize clinical factors, prognosis, and determinants of ischemic stroke recurrence.
- To compare clinical profiles and outcomes of recurrent vs. first-ever ischemic stroke patients.
Summary:
- A 17-year study of 605 patients with recurrent ischemic stroke revealed recurrence rates varied by subtype (atherothrombotic 26.2%, cardioembolic 24.4%, lacunar 21.8%).
- Independent predictors of recurrence included previous intracerebral hemorrhage, intermittent claudication, hypertension, diabetes, and age.
- In-hospital mortality was higher in recurrent stroke patients (16.2%) compared to first-ever stroke patients (12%).
Impact:
- Identifies key clinical variables associated with ischemic stroke recurrence, aiding in risk stratification.
- Highlights the differential prognosis and clinical characteristics of recurrent ischemic strokes.
- Informs clinical practice and future research directions for secondary stroke prevention.
Related Concept Videos
Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...
Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...