The cerebral vasculopathy of Fabry disease.
Fabry disease is an X-linked disorder affecting both males and females. It is associated with an increased risk of stroke in up to 4% of patients below 55 years of age in the general population. The cerebral vasculopathy consists of ischemic strokes involving large and small vessels. The neuronal accumulation of glycosphingolipids appears to have no clinical effect on the natural history of Fabry disease with the possible exception of some reported mild cognitive abnormalities. The pathogenesis of Fabry vasculopathy remains poorly understood but is associated with abnormal functional control of the vessel secondary to endothelial dysfunction, cerebral hyper-perfusion and a prothrombotic state with likely increased production of reactive oxygen species. These abnormalities are further modified by genetic and possibly other vascular risk factors. This vasculopathy illustrates the role of glycolipids in this and possibly other types of cerebral vasculopathies. Therapy is preventive relying on standard medical care and in particular on anti-platelet agents such as clopidogrel.
Moore
David F
DF
Section of Neurology, University of Manitoba, Room GF543, 820 Sherbrook Street, Winnipeg, Manitoba, Canada R3C 4J5.
Kaneski
Christine R
CR
Askari
Hasan
H
Schiffmann
Raphael
R
D000925:Anticoagulants / Q000627:therapeutic use; D001921:Brain / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology; D002536:Cerebral Arteries / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D002561:Cerebrovascular Disorders / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology; D000795:Fabry Disease / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D006028:Glycosphingolipids / Q000378:metabolism; D006801:Humans; D020767:Intracranial Thrombosis / Q000209:etiology / Q000503:physiopathology; D020521:Stroke / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control
D000925:Anticoagulants; D006028:Glycosphingolipids