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[The cerebral angiogram in cases of stroke in youth (author's transl)]
Insights
Investigating ischemic cerebral circulatory disturbances in young patients revealed that while most recovered well, angiographic findings of vessel stenosis or occlusion were more common than clinical presentation suggested. Comprehensive angiography of all head and neck vessels is recommended for accurate diagnosis.
Area of Science:
- Neurology
- Vascular Medicine
- Diagnostic Imaging
Background:
- Ischemic cerebral circulatory disturbances affect individuals across a wide age range, including younger populations.
- Understanding the underlying vascular pathology is crucial for effective management and prognosis.
- Clinical presentation alone may not fully capture the extent of cerebrovascular disease.
Purpose of the Study:
- To clinically and angiographically investigate patients with ischemic cerebral circulatory disturbances.
- To correlate clinical findings with angiographic evidence of stenoses or occlusions.
- To determine the recommended diagnostic approach for these conditions.
Main Methods:
- Clinical assessment of 67 patients (ages 11-40) with ischemic cerebral circulatory disturbances.
- Angiographic investigation, including panangiography of craniocervical vessels.
- Diagnosis of transient ischemic attacks (TIAs), reversible ischemic neurological defects (RINDs), and completed strokes.
Main Results:
- A high recovery rate (60/67 patients) was observed.
- Stenoses or occlusions were identified in only 21.5% of clinically affected vessel regions.
- Panangiography revealed stenoses or occlusions in 50% of patients, indicating subclinical disease.
Conclusions:
- Completed strokes often occurred without preceding transient ischemic attacks.
- Angiographic findings suggest a higher prevalence of stenotic lesions than clinical evaluation alone indicates.
- Comprehensive angiographic investigation of all craniocervical vessels is advisable for patients with cerebral circulatory disturbances.
Abstract:
Sixty-seven patients (ages: 11-40 years) suffering from ischemic cerebral circulatory disturbances were investigated clinically and angiographically. In 34 cases, transient ischemic attacks or reversible ischemic neurological defects were diagnosed; 33 patients suffered from completed strokes. In most cases the completed stroke took place without previous transient ischemic attacks. A very good tendency toward recovery was observed in 60 of 67 cases. Stenoses or occlusions were found in only 21.5% of the clinically affected vessel regions. However, 50% of those patients, on whom panangiography was performed, were shown to have stenoses or occlusions. Stenotic vessel wall lesions are also obviously to be expected in clinically nonaffected vessel regions; consequently, in cases of cerebral circulatory disturbances, angiographic investigation of all craniocervical vessels is advisable.