title: The course of unilateral intracranial arteriopathy in young adults with arterial ischemic stroke.
abstract: OBJECTIVE
  Unilateral intracranial focal nonprogressive arteriopathy is often found in children with arterial ischemic stroke. We aimed to investigate the course of unilateral intracranial arteriopathy in young adults.
  
  
  METHODS
  We searched the Utrecht Stroke Database for patients between 16 and 50 years of age diagnosed with anterior circulation arterial ischemic stroke and a nonatherosclerotic, unilateral intracranial large-artery arteriopathy between 1991 and 2005. We assessed clinical features, potential causes, risk factors, extent of infarction and arteriopathy at presentation, long-term angiographic course, and clinical outcome.
  
  
  RESULTS
  Of 356 patients with anterior circulation arterial ischemic stroke, 17 (5%) had a documented unilateral intracranial arteriopathy, of whom 14 could be included for follow-up investigations (median age, 34 years; range, 27-49 years). Median duration of follow-up was 8.8 years (range, 1.7-12.8 years). In 11 patients, onset of symptoms was not abrupt. The arteriopathy normalized completely in 5 and improved in 3 patients; in none of the patients did the arteriopathy worsen. Two of 14 patients had recurrent symptoms. Ten patients (71%) had a good outcome (modified Rankin Scale score≤2).
  
  
  CONCLUSIONS
  In young adults, arterial ischemic stroke is rarely caused by a unilateral intracranial arteriopathy. Similar to children, onset of symptoms in young adults is often not abrupt and the arteriopathy may improve over time. Late recurrences were rare. Possibly, a monophasic inflammatory process, as has been suggested for childhood intracranial focal nonprogressive arteriopathies, also occurs in young adults.
authors.affiliation: Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, HP G03.228, PO Box 85500, 3508 GA Utrecht, The Netherlands. M.M.M.Bulder@umcutrecht.nl
authors.forename: Marcel M M
authors.initials: MM
authors.lastname: Bulder
authors.forename: Kees P J
authors.initials: KP
authors.lastname: Braun
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Leeuwis
authors.forename: Rob T H
authors.initials: RT
authors.lastname: Lo
authors.forename: Onno
authors.initials: O
authors.lastname: van Nieuwenhuizen
authors.forename: L Jaap
authors.initials: LJ
authors.lastname: Kappelle
authors.forename: Catharina J M
authors.initials: CJ
authors.lastname: Klijn
mesh_terms: D000328:Adult; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D016208:Databases, Factual / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D020521:Stroke / Q000000981:diagnostic imaging* / Q000453:epidemiology*