title: Cryptogenic stroke in young patients: long-term prognosis and recurrence.
abstract: BACKGROUND
  Around 40% of strokes in young people are labelled as infarcts of undetermined cause. The aim of this study was to determine the image characteristics, the long-term functional outcome and recurrence after cryptogenic ischaemic stroke.
  
  
  METHODS
  We studied ninety-eight patients under 45 years of age during a median follow up of 54 months (range 12-238), with ischaemic stroke of undetermined cause. We registered vascular risk factors, clinical syndrome, laboratory and imaging results. We used Rankin disability score to assess functional outcome. The cases were evaluated with intracranial and extracranial vascular imaging studies, echocardiogram, and at least two determinations of prothrombotic states.
  
  
  RESULTS
  In our hospital 11% of the patients with cerebral infarction under 45 years of age were labelled as cryptogenic. The mean age of the cases was 39.5 ± 5, 48 (49%) were women, 6 (6%) had arterial hypertension, 7 (7%) prior history of migraine, 32 (33%) were active smokers, 11 (11%) had hypercholesterolemia, and 11 (11%) had alcoholism. All cases were treated with aspirin. We observed good functional outcome (Rankin 0-2) in 65 (65%) cases. The anterior circulation was the most affected (partial in 56%, total in 12%). Infarction was unique in 87 (88%) cases. Recurrence was observed in 4 (4%) cases.
  
  
  CONCLUSIONS
  In this study cryptogenic cerebral infarctions were mostly single, had low recurrence and good functional outcome in the long-term follow-up. Total anterior circulation infarctions correlated with poor outcome.
authors.affiliation: Clínica de Enfermedad Vascular Cerebral, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, México, México. arauzg@prodigy.net.mx
authors.forename: A
authors.initials: A
authors.lastname: Arauz
authors.forename: M
authors.initials: M
authors.lastname: Merlos-Benítez
authors.forename: L F
authors.initials: LF
authors.lastname: Roa
authors.forename: B
authors.initials: B
authors.lastname: Hernández-Curiel
authors.forename: C
authors.initials: C
authors.lastname: Cantú
authors.forename: L
authors.initials: L
authors.lastname: Murillo
authors.forename: J
authors.initials: J
authors.lastname: Roldán
authors.forename: J
authors.initials: J
authors.lastname: Vargas-Barrón
authors.forename: F
authors.initials: F
authors.lastname: Barinagarrementeria
mesh_terms: D000328:Adult; D000367:Age Factors; D002544:Cerebral Infarction / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D020521:Stroke / Q000175:diagnosis*; D013997:Time Factors; D055815:Young Adult