title: Acute cerebrovascular disease in the young: the Stroke in Young Fabry Patients study.
abstract: OBJECTIVE
  Strokes have especially devastating implications if they occur early in life; however, only limited information exists on the characteristics of acute cerebrovascular disease in young adults. Although risk factors and manifestation of atherosclerosis are commonly associated with stroke in the elderly, recent data suggests different causes for stroke in the young. We initiated the prospective, multinational European study Stroke in Young Fabry Patients (sifap) to characterize a cohort of young stroke patients.
  
  
  METHODS
  Overall, 5023 patients aged 18 to 55 years with the diagnosis of ischemic stroke (3396), hemorrhagic stroke (271), transient ischemic attack (1071) were enrolled in 15 European countries and 47 centers between April 2007 and January 2010 undergoing a detailed, standardized, clinical, laboratory, and radiological protocol.
  
  
  RESULTS
  Median age in the overall cohort was 46 years. Definite Fabry disease was diagnosed in 0.5% (95% confidence interval, 0.4%-0.8%; n=27) of all patients; and probable Fabry disease in additional 18 patients. Males dominated the study population (2962/59%) whereas females outnumbered men (65.3%) among the youngest patients (18-24 years). About 80.5% of the patients had a first stroke. Silent infarcts on magnetic resonance imaging were seen in 20% of patients with a first-ever stroke, and in 11.4% of patients with transient ischemic attack and no history of a previous cerebrovascular event. The most common causes of ischemic stroke were large artery atherosclerosis (18.6%) and dissection (9.9%).
  
  
  CONCLUSIONS
  Definite Fabry disease occurs in 0.5% and probable Fabry disease in further 0.4% of young stroke patients. Silent infarcts, white matter intensities, and classical risk factors were highly prevalent, emphasizing the need for new early preventive strategies.  Clinical Trial Registration Information- URL: http://www.clinicaltrials.gov.Unique identifier: NCT00414583.
authors.affiliation: Albrecht-Kossel-Institute for Neuroregeneration, Medical Faculty, University of Rostock, Gehlsheimer St.20, 18147 Rostock, Germany. arndt.rolfs@med.uni-rostock.de
authors.forename: Arndt
authors.initials: A
authors.lastname: Rolfs
authors.forename: Franz
authors.initials: F
authors.lastname: Fazekas
authors.forename: Ulrike
authors.initials: U
authors.lastname: Grittner
authors.forename: Martin
authors.initials: M
authors.lastname: Dichgans
authors.forename: Peter
authors.initials: P
authors.lastname: Martus
authors.forename: Martin
authors.initials: M
authors.lastname: Holzhausen
authors.forename: Tobias
authors.initials: T
authors.lastname: Böttcher
authors.forename: Peter U
authors.initials: PU
authors.lastname: Heuschmann
authors.forename: Turgut
authors.initials: T
authors.lastname: Tatlisumak
authors.forename: Christian
authors.initials: C
authors.lastname: Tanislav
authors.forename: Gerhard J
authors.initials: GJ
authors.lastname: Jungehulsing
authors.forename: Anne-Katrin
authors.initials: AK
authors.lastname: Giese
authors.forename: Jukaa
authors.initials: J
authors.lastname: Putaala
authors.forename: Roman
authors.initials: R
authors.lastname: Huber
authors.forename: Ulf
authors.initials: U
authors.lastname: Bodechtel
authors.forename: Christoph
authors.initials: C
authors.lastname: Lichy
authors.forename: Christian
authors.initials: C
authors.lastname: Enzinger
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schmidt
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hennerici
authors.forename: Manfred
authors.initials: M
authors.lastname: Kaps
authors.forename: Christof
authors.initials: C
authors.lastname: Kessler
authors.forename: Karl
authors.initials: K
authors.lastname: Lackner
authors.forename: Eduard
authors.initials: E
authors.lastname: Paschke
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Meyer
authors.forename: Hermann
authors.initials: H
authors.lastname: Mascher
authors.forename: Olaf
authors.initials: O
authors.lastname: Riess
authors.forename: Edwin
authors.initials: E
authors.lastname: Kolodny
authors.forename: Bo
authors.initials: B
authors.lastname: Norrving
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D015331:Cohort Studies; D005060:Europe / Q000453:epidemiology; D000795:Fabry Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000453:epidemiology* / Q000235:genetics; D055815:Young Adult