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[Contribution of cerebral angiography to the prognosis of juvenile stroke]
Insights
Severe stenoses/occlusions in craniocervical vessels indicate a worse prognosis for young patients with ischemic cerebrovascular disease. Vertebro-basilar system involvement shows a more favorable outcome than carotid system disease.
Area of Science:
- Neurology
- Vascular Medicine
- Radiology
Context:
- Investigated 46 young patients (13-40 years) with ischemic cerebrovascular disease.
- Utilized complete 4-vessel angiography for detailed vascular assessment.
- Included a follow-up examination for 40 patients after a mean of 57 months.
Purpose:
- To explore correlations between angiographic findings and long-term clinical outcomes.
- To assess the prognostic value of craniocervical vessel stenoses/occlusions.
- To compare the clinical course based on the location of vascular changes.
Summary:
- No significant difference in prognosis for non-surgically treated patients with or without craniocervical stenoses/occlusions.
- Severe stenoses/occlusions correlated with a significantly worse prognosis compared to mild stenoses.
- Vertebro-basilar system involvement showed a more favorable clinical course than carotid system involvement.
- A trend towards worse outcomes was observed with degenerative changes in small intracranial arteries.
Impact:
- Highlights the prognostic significance of stenosis severity and location in young patients with cerebrovascular disease.
- Informs clinical management and risk stratification strategies.
- Discusses the distinct prognostic value of cerebral angiography in young versus older stroke patients.
Abstract:
46 patients (aged 13 to 40 years) suffering from ischaemic cerebrovascular disease were investigated by means of complete 4-vessel angiography. 40 of these patients were re-examined after a mean follow-up period of 57 months. The aim of the study was to investigate possible connections between the angiographic data and the clinical condition some years later. In the 37 patients who were not subjected to surgical treatment prognosis was not significantly different in cases with, and those without stenoses/occlusions in the craniocervical vessels. However, patients suffering from severe stenoses/occlusions had a significantly worse prognosis than patients with stenoses of a mild degree. The clinical course in patients with stenoses/occlusions localized in the vertebro-basilar system was significantly more favourable than the course of the disease in patients with similar changes in the carotid system. There was a trend towards a worse clinical picture at the end of the follow-up period in cases with degenerative alterations in the small intracranial arteries. The difference in prognostic value of cerebral 4-vessel angiography in cases of stroke in the young, as opposed to the findings in older patients is discussed.