title: Cerebral ischemia in young patients (under 45 years of age): clinical and neuroradiological follow-up.
abstract: Ischemic stroke in young patients is a relatively rare event. Few studies have examined the long-term prognosis. The aim of this study was to evaluate the long-term outcome to identify clinical, laboratory and radiologic patterns as possible predictors for mortality, recurrence and functional recovery. We prospectively evaluated 94 patients (42 males and 52 females, aged 14-45 years, mean age 35.5 years, SD 8.4) admitted to our Neurological Department, for first acute ischemic stroke. A 48-month follow-up was performed. The patients were classified according to TOAST and Baltimore classification and Bamford criteria. The severity of the neurological deficit on admission was assessed using the NIHSS. The follow-up included a clinical visit, the modified Ranking scale (mRs) score, Barthel index (BI), and magnetic resonance imaging and intra-extracranial vessel Angio MRI. A good functional outcome (mRS 0-1) was found in 74 patients and unfavourable outcome (mRS 2-6) in 20 patients. 16 patients had a recurrent cerebral ischemic event: 5 patients had stroke and 11 patients had TIA. The average incidence annual rate of recurrence was 4.5% and a mortality rate was of 1.06%. Our study does not demonstrate any predictive factor related to clinical outcome. The relevant data of neuroradiological follow-up is the presence of clinically silent lesions in nine patients, considered as a recurrent stroke. To attribute a prognostic role to these lesions, clinical and neuroradiological follow-up needs to be continued.
authors.affiliation: Azienda Ospedaliera Sant'Andrea, Stroke Unit, Neurologia II Facoltà di Medicina e Chirurgia Università di Roma Sapienza, Via di Grottarossa 1035, 00189 Rome, Italy. rosalba.patella@gmail.com
authors.forename: Rosalba
authors.initials: R
authors.lastname: Patella
authors.forename: Alessandra
authors.initials: A
authors.lastname: Spalloni
authors.forename: Marco
authors.initials: M
authors.lastname: Ferrari
authors.forename: Sara
authors.initials: S
authors.lastname: La Starza
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bozzao
authors.forename: Maurizia
authors.initials: M
authors.lastname: Rasura
mesh_terms: D000293:Adolescent; D000328:Adult; D002545:Brain Ischemia / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult