Risk Of Early Stroke Research Articles

Natural history of asymptomatic ulcerative plaques of the carotid bifurcation

In 79 patients with 91 asymptomatic ulcerating lesions of the carotid bifurcation who were followed an average of 54 months, there were two strokes, one of which was preceded by a warning transient ischemic attack. These data suggest that asymptomatic type A and type B carotid ulcerating lesions do not carry a significant early risk of stroke and do not warrant prophylactic carotid endarterectomy. However, the effect of antiplatelet drugs and anticoagulation in enhancing the development of subintimal hemorrhagic lesions remains uncertain. Further data with serial follow-up, preferably by noninvasive means, will be necessary to define the evolution of asymptomatic ulcerating carotid plaques and eventually permit identification of those lesions that have significant stroke potential.

Stroke before fifty. Experiences from a five-year study.

Thirty-seven patients below the age of 50, with an acute first-time cerebrovascular lesion have been studied. Some form of predisposing factor was present in nearly all cases. There was a remarkably high incidence of cardiovascular and cerebrovascular disease among the parents of the stroke victims. Only 50% of the patients with hypertension known prior to the stroke had received adequate treatment. There were six females on oral contraceptives. The immediate mortality, i.e. within one month, was 35% essentially caused by a very high initial mortality among patients with cerebral haemorrhage. The patients were checked after 30 months. At this time, 16 patients were still alive and 11 able to perform some sort of work. Among the survivors there was a high incidence of diabetes and impaired glucose metabolism, to judge from intravenous glucose tolerance tests. The chances of survival and vocational rehabilitation seem to be fairly good, compared with higher age groups, thus urgently calling upon the resources of the community for active therapeutic measures and training. Individuals with hypertension and impaired glucose tolerance, with heredity for vascular disease and diabetes seem to be especially at risk for early stroke. Health surveys should be directed to tracing these subjects early.