Abstract Details

Title Prevalence and Determinants of White Matter Hyperintensities in Young Stroke Patients

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P03 - (-)

Poster/Presentation
Number 160

Objective

Background BACKGROUND: WMH, a commonly considered radiographic marker of small vessel disease, are well characterized in older populations while prevalence and associated risk factors in young patients presenting with ischemic or hemorrhagic strokes are limited.

Design/Methods DESIGN/METHODS: We retrospectively reviewed data of 146 patients aged 15 to 49 admitted consecutively to Boston Medical Center between 01/2006-02/2010 with a diagnosis of ischemic stroke (IS) or spontaneous intraparenchymal hemorrhage (IPH). Patients with interpretable T2/FLAIR sequences on MRI were eligible (n=115). WMH was graded according to the Age-Related White Matter Changes Scale. Cerebral volume was assessed using the Global Cortical Atrophy Scale. We compared demographic, clinical and radiographic characteristics at presentation for differences between patients with none-mild vs. moderate-severe WMHs.

Results RESULTS: WMHs were present in 66 (57%) patients (mean age 41years). WMHs were graded as mild, moderate and severe in 31%, 16% and 10% patients, respectively. WMHs were mostly bilateral subcortical (56%), and frequently located in parieto-occipital (49%) and frontal regions (47%). Patients with moderate-severe WMHs, in comparison with those with none-mild WMHs, were more likely to be hypertensive (76% vs. 34%, p<0.0001), with higher systolic (175 vs. 145 mmHg, p<0.0001) and diastolic (104.7 mmHg vs. 84.2 mmHg, p<0.0001) blood pressures, and higher mean serum creatinine (1.7 vs. 0.9 mg/dl, p<0.001) on presentation. Additionally, they were more likely to have had at least 1 (30% vs. 8%, p<0.01) and >10 (13% vs. 0%, p=0.01) cerebral microbleeds (CMBs), and moderate-severe cortical atrophy (27% vs. 7%, p<0.01).

Conclusions CONCLUSIONS: Our preliminary data suggest a high prevalence of WMHs in a young stroke population. We observed significant associations between mod-severe WMHs and hypertension, renal dysfunction, CMB burden, and cortical atrophy. Characterization of WMHs in young populations with specific stroke subtypes warrants further investigation.

Authors/Disclosures
Luciana Catanese, MD PRESENTER	Dr. Catanese has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for IschemiaCare.
Ashkan Shoamanesh, MD	Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer AG. Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Daiichi Sankyo . Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Servier Inc.. Dr. Shoamanesh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurodiem.ca. The institution of Dr. Shoamanesh has received research support from Servier Canada Inc.. The institution of Dr. Shoamanesh has received research support from Daiichi Sankyo Ltd.. The institution of Dr. Shoamanesh has received research support from Bayer AG. The institution of Dr. Shoamanesh has received research support from Bristol-Myers Squibb. The institution of Dr. Shoamanesh has received research support from Octapharma Canada .
Melissa L. Rayhill, MD, FAAN (UBMD Neurology/University At Buffalo SUNY)	Dr. Rayhill has received personal compensation in the range of $500-$4,999 for serving as a Presenter with Headache Cooperative of New England. Dr. Rayhill has received personal compensation in the range of $500-$4,999 for serving as a Presenter with Clusterbusters. Dr. Rayhill has received personal compensation in the range of $500-$4,999 for serving as a Presenter with ��ɫ��.
Helena W. Lau	No disclosure on file
Jose R. Romero, MD (Boston University School of Medicine - Boston Medical Center)	The institution of Dr. Romero has received research support from NIH/NIA.
Viken L. Babikian, MD, FAAN	Dr. Babikian has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boston Scientific. Dr. Babikian has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Baim Institute for Clinical Research. Dr. Babikian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Boston Scientific.
Oscar R. Benavente, MD, FRCP(C) (Gordon and Leslie Diamond Health Care Centre)	No disclosure on file
Carlos S. Kase, MD, FAHA, FAAN	Dr. Kase has nothing to disclose.
Aleksandra Pikula, MD	The institution of Dr. Pikula has received research support from CIHR.
Paolo Gallo, MD (Dompe' Biotec Italy)	Dr. Gallo has nothing to disclose.

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