title: Family history of stroke is an independent risk factor for lacunar stroke subtype with asymptomatic lacunar infarcts at younger ages.
abstract: OBJECTIVE
  Results from case-control and case-case studies indicate that a positive family history of stroke (FHstroke) is an independent risk factor for lacunar stroke. Different lacunar stroke phenotypes can be distinguished on the basis of the presence of asymptomatic lacunar infarcts (aLACs), ischemic white-matter lesions, or brain microbleeds. The aim of the present study was to determine whether familial aggregation of stroke was different for lacunar stroke phenotypes.
  
  
  METHODS
  In 157 patients with a first-ever lacunar stroke, a complete first-degree FHstroke was obtained by a standardized questionnaire and additional interview. Lacunar stroke patients were categorized successively into groups, depending on the presence of aLACs, ischemic white-matter lesions, and brain microbleeds on magnetic resonance imaging.
  
  
  RESULTS
  Fifty-two percent of patients reported a positive FHstroke in at least one of their first-degree relatives. In younger (<65 years) probands, a high frequency of parental FHstroke (59% versus 20%, P<0.01) in those with aLACs compared with probands without aLACs was found. In multivariate analysis, the strongest associations were found for parental FHstroke (odds ratio=6.46; 95% CI=1.96 to 21.33), maternal FHstroke (odds ratio=4.00; 95% CI=1.18 to 13.56), and paternal FHstroke (odds ratio=5.40; 95% CI=1.14 to 25.61).
  
  
  CONCLUSIONS
  A family history of stroke might be an independent risk factor for the lacunar stroke phenotype with aLACs at younger ages, suggesting a role for genetic factors in this phenotype caused by diffuse vasculopathy.
authors: Department of Neurology, Maastricht University Medical Centre, PO Box 5800, 6202 AZ Maastricht, The Netherlands. iris.knottnerus@home.nl
authors: Iris L H
authors: IL
authors: Knottnerus
authors: Marij
authors: M
authors: Gielen
authors: Jan
authors: J
authors: Lodder
authors: Rob P W
authors: RP
authors: Rouhl
authors: Julie
authors: J
authors: Staals
authors: Robert
authors: R
authors: Vlietinck
authors: Robert J
authors: RJ
authors: van Oostenbrugge
mesh_terms: D000367:Age Factors; D020520:Brain Infarction / Q000453:epidemiology* / Q000235:genetics*; D016022:Case-Control Studies; D005192:Family Health; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012307:Risk Factors; D020521:Stroke / Q000235:genetics*