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Статті в журналах з теми "Cerebrovascular disease Patients Australia"

Автор: Grafiati

Опубліковано: 10 грудня 2022

Оновлено: 28 січня 2023

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1

De La Mata, Nicole Louise, Maria Alfaro-Ramirez, Patrick J. Kelly, Philip Masson, Rustam Al-Shahi Salman, and Angela C. Webster. "Absolute risk and risk factors for stroke mortality in patients with end-stage kidney disease (ESKD): population-based cohort study using data linkage." BMJ Open 9, no. 2 (February 2019): e026263. http://dx.doi.org/10.1136/bmjopen-2018-026263.

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IntroductionPeople with end-stage kidney disease (ESKD) have up to 30-fold higher risk of stroke than the general population.ObjectiveTo determine risk factors associated with stroke death in the ESKD population.MethodsWe identified all patients with incident ESKD in Australia (1980–2013) and New Zealand (1988–2012) from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) registry. We ascertained underlying cause of death from data linkage with national death registries and risk factors from ANZDATA. Using a competing risks multivariable regression model, we estimated cumulative incidence of stroke and non-stroke deaths, and risk factors for stroke deaths (adjusted sub-HR, SHR).ResultsWe included 60 823 people with ESKD. There were 941 stroke deaths and 33 377 non-stroke deaths during 381 874 person-years of follow-up. Overall, the cumulative incidence of stroke death was 0.9% and non-stroke death was 36.8% 5 years after starting ESKD treatment. The risk of stroke death was higher at older ages (SHR 1.92, 95% CI 1.45 to 2.55), in females (SHR 1.41, 95% CI 1.21 to 1.64), in people with cerebrovascular disease (SHR 2.39, 95% CI 1.99 to 2.87), with ESKD caused by hypertensive/renovascular disease (SHR 1.39, 95% CI 1.09 to 1.78) or polycystic kidney disease (SHR 1.38, 95% CI 1.00 to 1.90), with earlier year of ESKD treatment initiation (SHR 1.93, 95% CI 1.56 to 2.39) and receiving dialysis (transplant vs haemodialysis SHR 0.27, 95% CI 0.09 to 0.84).ConclusionPatients with ESKD with higher risk of stroke death are older, women, with cerebrovascular disease, with hypertensive/renovascular or polycystic kidney disease cause of ESKD, with earlier year of ESKD treatment and receiving dialysis. These groups may benefit from targeted stroke prevention interventions.

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2

Atkins, Emily R., Elizabeth A. Geelhoed, Lee Nedkoff, and Tom G. Briffa. "Disparities in equity and access for hospitalised atherothrombotic disease." Australian Health Review 37, no. 4 (2013): 488. http://dx.doi.org/10.1071/ah13083.

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Objective. This study of equity and access characterises admissions for coronary, cerebrovascular and peripheral arterial disease by hospital type (rural, tertiary and non-tertiary metropolitan) in a representative Australian population. Methods. We conducted a descriptive analysis using data linkage of all residents aged 35–84 years hospitalised in Western Australia with a primary diagnosis for an atherothrombotic event in 2007. We compared sociodemographic and clinical features by atherothrombotic territory and hospital type. Results. There were 11670 index admissions for atherothrombotic disease in 2007 of which 46% were in tertiary hospitals, 41% were in non-tertiary metropolitan hospitals and 13% were in rural hospitals. Coronary heart disease comprised 72% of admissions, followed by cerebrovascular disease (19%) and peripheral arterial disease (9%). Comparisons of socioeconomic disadvantage reveal that for those admitted to rural hospitals, more than one-third were in the most disadvantaged quintile, compared with one-fifth to any metropolitan hospital. Conclusions. Significant differences in demographic characteristics were evident between Western Australian tertiary and non-tertiary hospitals for patients hospitalised for atherothrombotic disease. Notably, the differences among tertiary, non-tertiary metropolitan and rural hospitals were related to socioeconomic disadvantage. This has implications for atherothrombotic healthcare provision and the generalisation of research findings from studies conducted exclusively in the tertiary metropolitan hospitals. What is known about the topic? Equity and access to hospital care for atherothrombotic disease in a geographically diverse population is poorly characterised. National data show that both fatal and non-fatal coronary heart disease and non-fatal stroke hospitalisations increase with remoteness. Fatal in-hospital stroke is greatest in major cities, whereas peripheral arterial disease hospitalisations are greatest in the inner and outer regional areas. What does this paper add? This study demonstrates that around 13% of atherothrombotic events were treated in rural hospitals with in-hospital case fatality higher than in tertiary and non-tertiary metropolitan hospitals. A greater proportion of atherothrombotic disease cases treated in rural hospitals were in the most disadvantaged Socioeconomic Indices For Area group. What are the implications for practitioners? It is important to consider differences in disadvantage when generalising results of studies generated from tertiary hospital data to non-tertiary metropolitan and rural patients.

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3

Chan, Samuel, Mark R. Marshall, Robert J. Ellis, Dwarakanathan Ranganathan, Carmel M. Hawley, David W. Johnson, and Martin J. Wolley. "Haemodialysis withdrawal in Australia and New Zealand: a binational registry study." Nephrology Dialysis Transplantation 35, no. 4 (August 9, 2019): 669–76. http://dx.doi.org/10.1093/ndt/gfz160.

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Abstract Background Withdrawal from dialysis is an increasingly common cause of death in patients with end-stage kidney disease (ESKD). As most published reports of dialysis withdrawal have been outside the Oceania region, the aims of this study were to determine the frequency, temporal pattern and predictors of dialysis withdrawal in Australian and New Zealand patients receiving chronic haemodialysis. Methods This study included all people with ESKD in Australia and New Zealand who commenced chronic haemodialysis between 1 January 1997 and 31 December 2016, using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Competing risk regression models were used to identify predictors of dialysis withdrawal mortality, using non-withdrawal cause of death as the competing risk event. Results Among 40 447 people receiving chronic haemodialysis (median age 62 years, 61% male, 9% Indigenous), dialysis withdrawal mortality rates increased from 1.02 per 100 patient-years (11% of all deaths) during the period 1997–2000 to 2.20 per 100 patient-years (32% of all deaths) during 2013–16 (P < 0.001). Variables that were significantly associated with a higher likelihood of haemodialysis withdrawal were older age {≥70 years subdistribution hazard ratio [SHR] 1.77 [95% confidence interval (CI) 1.66–1.89]; reference 60–70 years}, female sex [SHR 1.14 (95% CI 1.09–1.21)], white race [Asian SHR 0.56 (95% CI 0.49–0.65), Aboriginal and Torres Strait Islander SHR 0.83 (95% CI 0.74–0.93), Pacific Islander SHR 0.47 (95% CI 0.39–0.68), reference white race], coronary artery disease [SHR 1.18 (95% CI 1.11–1.25)], cerebrovascular disease [SHR 1.15 (95% CI 1.08–1.23)], chronic lung disease [SHR 1.13 (95% CI 1.06–1.21)] and more recent era [2013–16 SHR 3.96 (95% CI 3.56–4.48); reference 1997–2000]. Conclusions Death due to haemodialysis withdrawal has become increasingly common in Australia and New Zealand over time. Predictors of haemodialysis withdrawal include older age, female sex, white race and haemodialysis commencement in a more recent era.

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4

Georgieva, Dobrinka, Dobrinka Kalpachka, and Rossen Kalpachki. "Stroke and aphasia rehabilitation: A comparison of international guidelines." Logopedia Silesiana, no. 9 (December 29, 2020): 1–15. http://dx.doi.org/10.31261/logopediasilesiana.2020.09.19.

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Cerebrovascular diseases are the leading cause of morbidity and mortality worldwide. Unfortunately, Bulgaria leads most countries in its incidence of stroke. Furthermore, a substantial number of Bulgarian patients post-stroke present with persisting communication disorders, especially aphasia. The main purpose of the present study is to conduct an evidence-based theoretical review of leading international guidelines for treatment and rehabilitation of adult stroke patients. In particular, this theoretical overview compares the current Bulgarian guidelines with those developed by the United States of America, Europe, Australia, Canada, the United Kingdom, and New Zealand. The Bulgarian guidelines for the prevention, diagnosis, and treatment of cerebrovascular diseases strongly recommends pharmacological treatment, which is commensurate with international standards. Nationally, a range of different language tests are currently used in post-stroke aphasia.

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Blair, Christopher, Angela Firtko, Peter Thomas, Longting Lin, Megan Miller, Lisa Tran, Leon Edwards, Sonu Bhaskar, Mark Parsons, and Dennis J. Cordato. "A Multicentre Study Comparing Cerebrovascular Disease Profiles in Pacific Islander and Caucasian Populations Presenting with Stroke and Transient Ischaemic Attack." Neuroepidemiology 56, no. 1 (December 1, 2021): 25–31. http://dx.doi.org/10.1159/000520058.

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Introduction: In a multicentre study, we contrasted cerebrovascular disease profiles in Pacific Island (PI)-born patients (Indigenous Polynesian [IP] or Indo-Fijian [IF]) presenting with transient ischaemic attack (TIA), ischaemic stroke (IS) or intracerebral haemorrhage (ICH) with those of Caucasians (CSs). Methods: Using a retrospective case-control design, we compared PI-born patients with age- and gender-matched CS controls. Consecutive patients were admitted to 3 centres in South Western Sydney (July 2013–June 2020). Demographic and clinical data studied included vascular risk factors, stroke subtypes, and imaging characteristics. Results: There were 340 CS, 183 (27%) IP, and 157 (23%) IF patients; mean age 65 years; and 302 (44.4%) female. Of these, 587 and patients presented with TIA/IS and 93 (13.6%) had ICH. Both IP and IF patients were significantly more likely to present >24 h from symptom onset (odds ratios [ORs] vs. CS 1.87 and 2.23). IP patients more commonly had body mass indexes >30 (OR 1.94). Current smoking and excess alcohol intake were higher in CS. Hypertension, diabetes, and chronic kidney disease were significantly higher in both IP and IF groups in comparison to CS. IP patients had higher rates of AF and those with known AF were more commonly undertreated than both IF and CS patients (OR 2.24, p = 0.007). ICH was more common in IP patients (OR 2.32, p = 0.005), while more IF patients had intracranial arterial disease (OR 5.10, p < 0.001). Discussion/Conclusion: Distinct cerebrovascular disease profiles are identifiable in PI-born patients who present with TIA or stroke symptoms in Australia. These may be used in the future to direct targeted approaches to stroke prevention and care in culturally and linguistically diverse populations.

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Davis, Wendy A., Eunice Chin, Adelle Jee, Jen Martins, David G. Bruce, John Beilby, and Timothy M. E. Davis. "Apolipoprotein E genotype and mortality in Southern European and Anglo-Celt patients with type 2 diabetes: the Fremantle Diabetes Study." European Journal of Endocrinology 163, no. 4 (October 2010): 559–64. http://dx.doi.org/10.1530/eje-10-0474.

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ObjectiveTo determine whether cardiac and all-cause mortality are lower in Southern European (SE) patients than in Anglo-Celt (AC) patients with type 2 diabetes in an urban Australian setting, and, if so, whether ethnicity-specific differences in apolipoprotein E (APOE) genotypes are contributory.DesignLongitudinal observational cohort study.MethodsWe analysed detailed data from 1057 patients from the community-based Fremantle Diabetes Study, 238 were of an SE migrant background and 819 of AC ethnicity. Cox proportional hazards modelling was used to identify independent predictors of cardiac and all-cause mortality.ResultsDuring 9.8±3.5 years of follow-up, 411 (38.9%) participants died, 161 (39.2%) from cardiac causes. Significant positive baseline independent predictors of cardiac death were age, male gender, coronary heart disease, cerebrovascular disease, peripheral arterial disease, retinopathy and peripheral neuropathy (P≤0.004), while maternal history of diabetes was protective (P=0.014). After adjusting for these variables,APOE4carriage was predictive (hazard ratio (95% confidence interval) 1.61 (1.01–2.58);P=0.048). SE ethnicity did not add significantly to the model either as a single variable or as an interaction term withAPOE4carriage (P≥0.86). Significant independent predictors of all-cause mortality were age, male gender, smoking, coronary heart disease, cerebrovascular disease, peripheral arterial disease, retinopathy, peripheral neuropathy and microalbuminuria (P≤0.047), while overweight/obesity, lipid-lowering therapy and recent exercise were protective (P≤0.008).APOE4carriage, SE ethnicity and their interaction did not add to the model (P≥0.32).ConclusionsSE ethnicity does not confer an independent survival advantage in community-based Australian type 2 diabetic patients, butAPOE4carriers are at higher risk of cardiac death.

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Laupland, Kevin B., Mahesh Ramanan, Kiran Shekar, Felicity Edwards, Pierre Clement, and Alexis Tabah. "Long-term outcome of prolonged critical illness: A multicentered study in North Brisbane, Australia." PLOS ONE 16, no. 4 (April 8, 2021): e0249840. http://dx.doi.org/10.1371/journal.pone.0249840.

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Background Although critical illness is usually of high acuity and short duration, some patients require prolonged management in intensive care units (ICU) and suffer long-term morbidity and mortality. Objective To describe the long-term survival and examine determinants of death among patients with prolonged ICU admission. Methods A retrospective cohort of adult Queensland residents admitted to ICUs for 14 days or longer in North Brisbane, Australia was assembled. Comorbid illnesses were classified using the Charlson definitions and all cause case fatality established using statewide vital statistics. Results During the study a total of 28,742 adult Queensland residents had first admissions to participating ICUs of which 1,157 (4.0%) had prolonged admissions for two weeks or longer. Patients with prolonged admissions included 645 (55.8%), 243 (21.0%), and 269 (23.3%) with ICU lengths of stay lasting 14–20, 21–27, and ≥28 days, respectively. Although the severity of illness at admission did not vary, pre-existing comorbid illnesses including myocardial infarction, congestive heart failure, kidney disease, and peptic ulcer disease were more frequent whereas cancer, cerebrovascular accidents, and plegia were less frequently observed among patients with increasing ICU lengths of stay lasting 14–20, 21–27, and ≥28 days. The ICU, hospital, 90-day, and one-year all cause case-fatality rates were 12.7%, 18.5%, 20.2%, and 24.9%, respectively, and were not different according to duration of ICU stay. The median duration of observation was 1,037 (interquartile range, 214–1888) days. Although comorbidity, age, and admitting diagnosis were significant, neither ICU duration of stay nor severity of illness at admission were associated with overall survival outcome in a multivariable Cox regression model. Conclusions Most patients with prolonged stays in our ICUs are alive at one year post-admission. Older age and previous comorbidities, but not severity of illness or duration of ICU stay, are associated with adverse long-term mortality outcome.

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Koh, Youlin, Julia Stehli, Catherine Martin, Angela Brennan, Diem T. Dinh, Jeffrey Lefkovits, and Sarah Zaman. "Does sex predict quality of life after acute coronary syndromes: an Australian, state-wide, multicentre prospective cohort study." BMJ Open 9, no. 12 (December 2019): e034034. http://dx.doi.org/10.1136/bmjopen-2019-034034.

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ObjectiveWomen have reported higher mortality and major adverse cardiovascular events (MACE) following acute coronary syndromes (ACSs) compared with men. With this in mind, we aimed to identify predictors of poor quality of life (QoL) post-ACS as our primary outcome. We examined predictors of MACE, major cerebrovascular events and major bleeding as our secondary outcome.DesignProspective cohort study.Setting30 metropolitan centres across the Victorian Cardiac Outcomes Registry network.Participants16 517 patients treated with percutaneous coronary intervention (PCI) for ACS (22.9% females). Selection/inclusion criteria: consecutive patients with successful or attempted PCI for ACS from 2013 to 2016, alive at 30 days post-PCI. Exclusion criteria: patients not fulfilling ACS criteria. At 30 days, 2497 (64.7% females) completed the QoL EQ-5D-3L instrument.Primary and secondary outcome measuresQoL, assessed using the EuroQo-5Dimensions (EQ-5D-3L) instrument by telephone at 30 days. Independent predictors of QoL were identified by univariate and multivariate logistic regression analyses.ResultsWomen were significantly older with more diabetes, cerebrovascular disease and renal failure. Regarding the primary outcome, female sex was independently associated with moderate/severe impairment in all EQ-5D-3L domains including mobility (OR 2.38, 95% CI 2.06 to 2.75, p<0.001), personal care (OR 2.14, 95% CI 1.73 to 2.66, p<0.001), activities of daily living (OR 1.84, 95% CI 1.63 to 2.08, p<0.001), pain/discomfort (OR 1.44, 95% CI 1.24 to 1.67, p<0.001) and anxiety/depression (OR 1.49, 95% CI 1.30 to 1.70, p<0.001). Women had significantly lower self-rated Visual Analogue Scale scores (80.0 for both groups, IQR 60-85 vs 70-90, p<0.001). There was no significant difference between the sexes in secondary outcomes.ConclusionsFemale sex was a predictor of poorer QoL following PCI for ACS including significantly higher pain, anxiety and depression. This was independent of age, comorbidities and ACS presentation. There is a clinical need for a tailored approach in female ACS management, for example, emphasis on management of depressive and anxiety symptoms.

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Koshy, Anoop N., Paul J. Gow, Hui-Chen Han, Andrew W. Teh, Robert Jones, Adam Testro, Han S. Lim, et al. "Cardiovascular mortality following liver transplantation: predictors and temporal trends over 30 years." European Heart Journal - Quality of Care and Clinical Outcomes 6, no. 4 (February 26, 2020): 243–53. http://dx.doi.org/10.1093/ehjqcco/qcaa009.

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Abstract Aims There has been significant evolution in operative and post-transplant therapies following liver transplantation (LT). We sought to study their impact on cardiovascular (CV) mortality, particularly in the longer term. Methods and results A retrospective cohort study was conducted of all adult LTs in Australia and New Zealand across three 11-year eras from 1985 to assess prevalence, modes, and predictors of early (≤30 days) and late (>30 days) CV mortality. A total of 4265 patients were followed-up for 37 409 person-years. Overall, 1328 patients died, and CV mortality accounted for 228 (17.2%) deaths. Both early and late CV mortality fell significantly across the eras (P < 0.001). However, CV aetiologies were consistently the leading cause of early mortality and accounted for ∼40% of early deaths in the contemporary era. Cardiovascular deaths occurred significantly later than non-cardiac aetiologies (8.8 vs. 5.2 years, P < 0.001). On multivariable Cox regression, coronary artery disease [hazard ratio (HR) 4.6, 95% confidence interval (CI) 1.2–21.6; P = 0.04] and era of transplantation (HR 0.44; 95% CI 0.28–0.70; P = 0.01) were predictors of early CV mortality, while advancing age (HR 1.05, 95% CI 1.02–1.10; P = 0.005) was an independent predictors of late CV mortality. Most common modes of CV death were cardiac arrest, cerebrovascular events, and myocardial infarction. Conclusion Despite reductions in CV mortality post-LT over 30 years, they still account for a substantial proportion of early and late deaths. The late occurrence of CV deaths highlights the importance of longitudinal follow-up to study the efficacy of targeted risk-reduction strategies in this unique patient population.

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Hsu, Danny, Ibrahim Tohidi-Esfahani, Christina Brown, Scott Dunkley, Stephen Robert Larsen, Phoebe Joy Ho, Harry Iland, John Gibson, and Douglas E. Joshua. "Safety and Efficacy of CEEP (Cyclophosphamide, Epirubicin, Etoposide, Prednisolone) with or without Rituximab in Elderly Patients (>70) with Diffuse Large B-Cell Lymphoma (DLBL): A Retrospective Single Center Experience." Blood 118, no. 21 (November 18, 2011): 4957. http://dx.doi.org/10.1182/blood.v118.21.4957.4957.

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Abstract Abstract 4957 Background Over 40% of patients with the most common lymphoid malignancy worldwide, DLBL, are over the age of 70. Although R-CHOP is inarguably the mainstay of therapy for DLBL patients, a significant number of elderly patients do not tolerate the regimen due to underlying frailty and/or co-morbidities. Most elderly patients with significant co-morbidities have limited treatment options and are not offered anthracycline-containing chemotherapy due to concerns regarding toxicity. Here we describe our single center experience with CEEP, a lower intensity regimen for elderly patients with newly diagnosed or relapsed DLBL whom are deemed inappropriate for CHOP-based chemotherapy. Method All patients >70 years old (median 78.5, range 71 – 85) with histologically proven DLBL treated with CEEP ± Rituximab (R) at Royal Prince Alfred Hospital from 2000 to 2010 were retrospectively reviewed. Modified CEEP, Cyclophosphamide 300mg/m2 Day 1 (D1) and D15, Epirubicin 50mg/m2 D1 and D15, Etoposide 100mg/m2 D1 and D15, and Prednisolone 50mg D1-D5 (reduced dose from original CEEP protocol) was administered every 2 weeks. Rituximab 375mg/m2 (when approved for use in Australia) was administered every 28 days. As per institutional protocol, all patients received Bactrim prophylaxis for Pneumocystis. Baseline characteristics, Charlson Comorbidity Index, Revised International Prognostic Index (RIPI), the number of CEEP cycles, treatment response and toxicity from treatment were identified and reviewed. Results A total of 22 patients were identified, 10 were male. 15 received CEEP as initial therapy, and 7 for relapsed disease. 23% (n=5) had an ECOG score ≥ 2. 55% (n=12) had RIPI ≥ 3. All patients had a Charlson Comorbidity Index ≥ 2, with 23% (n=5) ≥ 5, which was considered sufficient to preclude conventional CHOP-based chemotherapy. Median cardiac ejection fraction was 62% (range 55 – 85%). 73% (n=16) received Rituximab and 50% (n=11) received primary GCSF prophylaxis. The median number of CEEP ± R cycles was 6 (range 2 – 9 cycles). 5% (n=1) required dose reduction and 9% (n=2) required delays in treatment due to haematological toxicity. Median follow-up was 10.0 months (range 1 – 92.7 months). At completion of therapy, complete responses (CR) were demonstrated in 10 patients (45%), with partial responses (PR) seen in 32% (n=7). 18% (n=4) demonstrated progressive disease (PD) despite therapy. Of the 7 patients with relapsed disease prior to CEEP ± R, CR was seen in 2 cases, both of whom had previous exposure to R-CVP (cyclophosphamide, vincristine, prednisolone) chemotherapy. At most recent follow up, 32% (n=7) have remained in CR with a median follow up period of 28.1 months (range 13 – 92.7 months), 36% (n=8) had disease progression, 9% (n=2) demonstrated stable residual disease, while 23% (n=5) have died. Of the 5 deaths, 3 were attributed to progressive DLBL. The other deaths were a result of complications following further salvage chemotherapy. Grade 3 – 4 haematological toxicity was observed in 72% (n=16) of patients. Febrile neutropenia occurred in 41% (n=9). Overall, 50% (n=11) required at least one re-admission to hospital. Non-haematological grade 3 – 4 toxicity was detected in 2 patients, one of whom suffered unstable angina in the setting of anaemia, the other an acute cerebrovascular event in the setting of new atrial flutter post-chemotherapy. Discussion Although limited by a small sample size, our retrospective single center experience demonstrates that CEEP ± R chemotherapy can be administered to elderly patients with significant co-morbidities. Our cohort was all aged >70, with medical co-morbidities leading to the unsuitability of conventional CHOP-based therapy. Whilst an overall response rate of 77% (CR + PR) was observed, on prolonged follow up, 32% of patients remained in CR. Significant haematological toxicity (72%) and infectious complications (41%) were observed, however no deaths were directly attributed to the chemotherapy. Future prospective studies are required to further evaluate the safety and efficacy of R-CEEP in the elderly. Disclosures: No relevant conflicts of interest to declare.

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Rotta, Newra Tellechea, Alexandre Rodrigues da Silva, Flora Luciana Figueira da Silva, Lygia Ohlweiler, Eraldo Belarmino Jr, Valéria Raimundo Fonteles, Josiane Ranzan, Orlando Javier Ramos Rodriguez, and Régis Osório Martins. "Cerebrovascular disease in pediatric patients." Arquivos de Neuro-Psiquiatria 60, no. 4 (December 2002): 959–63. http://dx.doi.org/10.1590/s0004-282x2002000600013.

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Although rare in childhood, stroke may have a serious impact when it happens in this stage of life. Also, it may be the first sign of a systemic disease. We report 12 cases of patients with stroke treated in the Neuropediatrics Unit of Hospital de Clínicas de Porto Alegre (HCPA) from March 1997 to March 2000. All patients, from term infants to 12-year-old children hospitalized in the Pediatrics Unit of HCPA, had clinical suspicion of stroke, which was later confirmed by radiological studies. Patient follow up ranged from 1 to 6 years (mean = 3.4 years). Presenting symptoms were hemiparesis in 9 patients, seizures in 7, deviation of labial commissure in 3, and loss of consciousness in 1. The increase in the number of cases of childhood stroke identified and later confirmed by noninvasive methods had helped in the determination of different ethiologies of stroke: the most frequent being hematologic, cardiac and genetic diseases. However, our study included 6 newborns with stroke whose ethiology was not identified. Seven children with seizures received phenobarbital. Six term infants had neonatal seizures secondary to stroke and restricted to the first 72 hours of life.

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Grotta, James. "Cerebrovascular Disease in Young Patients." Thrombosis and Haemostasis 78, no. 01 (1997): 013–23. http://dx.doi.org/10.1055/s-0038-1657494.

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AL-ROOMI, K. A., A. J. DOBSON, E. HALL, R. F. HELLER, and P. MAGNUS. "DECLINING MORTALITY FROM ISCHEMIC HEART DISEASE AND CEREBROVASCULAR DISEASE IN AUSTRALIA." American Journal of Epidemiology 129, no. 3 (March 1989): 503–10. http://dx.doi.org/10.1093/oxfordjournals.aje.a115161.

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Kitamura, Shin. "Neuroimaging in patients with cerebrovascular disease." Journal of Nippon Medical School 61, no. 5 (1994): 510–11. http://dx.doi.org/10.1272/jnms1923.61.510.

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Ward, G., K. Jamrozik, and E. Stewart-Wynne. "Incidence and outcome of cerebrovascular disease in Perth, Western Australia." Stroke 19, no. 12 (December 1988): 1501–6. http://dx.doi.org/10.1161/01.str.19.12.1501.

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YAMAMOTO, Sumiko. "Gait Analysis of Patients with Cerebrovascular Disease." Rigakuryoho Kagaku 17, no. 1 (2002): 3–10. http://dx.doi.org/10.1589/rika.17.3.

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ISHIBASHI, AKIRA, and YOSHITAKE YOKOKURA. "Outcomes in Patients with Ischemic Cerebrovascular Disease." Kurume Medical Journal 48, no. 3 (2001): 223–26. http://dx.doi.org/10.2739/kurumemedj.48.223.

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Perju-Dumbrava, Laura, Maria-Lucia Muntean, and Dafin Muresanu. "Cerebrovascular Profile Assessment in Parkinson’s Disease Patients." CNS & Neurological Disorders - Drug Targets 13, no. 4 (July 31, 2014): 712–17. http://dx.doi.org/10.2174/1871527313666140618110409.

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Passavanti, MB, MA Tedesco, F. Massimo, G. Ratti, G. Di Salvo, F. Argenzio, G. Limongelli, C. Aurilio, and M. Chiefari. "Electrocardiographic abnormalities in patients with cerebrovascular disease." Critical Care 2, Suppl 1 (1998): P060. http://dx.doi.org/10.1186/cc190.

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Mochio, Soichiro, Takeo Hasunuma, Hisayoshi Oka, Kenichi Sato, and Akira Kurita. "Magnetic stimulation in patients with cerebrovascular disease." Nosotchu 14, no. 5 (1992): 555–58. http://dx.doi.org/10.3995/jstroke.14.555.

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21

Tabuchi, Sadaharu. "Auditory Dysfunction in Patients with Cerebrovascular Disease." Scientific World Journal 2014 (2014): 1–8. http://dx.doi.org/10.1155/2014/261824.

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Анотація:

Auditory dysfunction is a common clinical symptom that can induce profound effects on the quality of life of those affected. Cerebrovascular disease (CVD) is the most prevalent neurological disorder today, but it has generally been considered a rare cause of auditory dysfunction. However, a substantial proportion of patients with stroke might have auditory dysfunction that has been underestimated due to difficulties with evaluation. The present study reviews relationships between auditory dysfunction and types of CVD including cerebral infarction, intracerebral hemorrhage, subarachnoid hemorrhage, cerebrovascular malformation, moyamoya disease, and superficial siderosis. Recent advances in the etiology, anatomy, and strategies to diagnose and treat these conditions are described. The numbers of patients with CVD accompanied by auditory dysfunction will increase as the population ages. Cerebrovascular diseases often include the auditory system, resulting in various types of auditory dysfunctions, such as unilateral or bilateral deafness, cortical deafness, pure word deafness, auditory agnosia, and auditory hallucinations, some of which are subtle and can only be detected by precise psychoacoustic and electrophysiological testing. The contribution of CVD to auditory dysfunction needs to be understood because CVD can be fatal if overlooked.

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22

Britton, M., U. Faire, C. Helmers, K. Miah, C. Ryding, and P. O. Wester. "Arrhythmias in Patients with Acute Cerebrovascular Disease." Acta Medica Scandinavica 205, no. 1-6 (April 24, 2009): 425–28. http://dx.doi.org/10.1111/j.0954-6820.1979.tb06076.x.

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23

Erfurth, Eva Marie, and Lars Hagmar. "Cerebrovascular disease in patients with pituitary tumors." Trends in Endocrinology & Metabolism 16, no. 7 (September 2005): 334–42. http://dx.doi.org/10.1016/j.tem.2005.07.004.

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24

Caplan, Louis R., and Fong Kwong Sonny Hon. "Clinical diagnosis of patients with cerebrovascular disease." Primary Care: Clinics in Office Practice 31, no. 1 (March 2004): 95–109. http://dx.doi.org/10.1016/s0095-4543(03)00118-0.

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25

Lehmann, E. D., K. D. Hopkins, R. L. Jones, A. G. Rudd, and R. G. Gosling. "Aortic Distensibility in Patients with Cerebrovascular Disease." Clinical Science 89, no. 3 (September 1, 1995): 247–53. http://dx.doi.org/10.1042/cs0890247.

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1. Non-invasive aortic compliance measurements have been used previously to assess the distensibility of the aorta in several pathological conditions associated with increased cardiovascular risk. We set out to establish whether aortic compliance is abnormal in patients with stroke. 2. Pulse wave velocity measurements of thoracoabdominal aortic compliance were made in 20 stroke patients and 25 age- and sex-matched hospitalized, non-stroke control subjects putatively free of cardiovascular disease. Since compliance varies with non-chronic changes in blood pressure, a blood pressure corrected index of aortic distensibility, Cp, was calculated. 3. Aortic compliance was significantly reduced in patients with stroke compared with non-stroke control subjects (0.46 ± 0.27 versus 0.86 ± 0.34%/10 mmHg, P < 0.0002), corresponding with higher values for pulse wave velocity. Stroke patients also had significantly higher systolic and diastolic blood pressures (P < 0.02 and P < 0.002 respectively) and total cholesterol levels (P < 0.004) than the control subjects. Calculation of Cp did not alter the observation of stiffer aortas in the stroke cohort (P < 0.0007). 4. In both stroke patient and control cohorts, as expected, inverse trends were observed between aortic compliance and blood pressure. Also as expected, in the control group Cp values did not show a relationship with blood pressure (r = 0.02, P = 0.092, not significant). However, in the stroke cohort a marked dependence of Cp on blood pressure was observed (r = −0.48, P = 0.03). 5. Transoesophageal echocardiographic studies have recently identified advanced atherosclerosis in the ascending aorta as a possible source of cerebral emboli and an independent risk factor for ischaemic stroke. Our observations of significantly stiffer thoracoabdominal aortas in patients with stroke lead us to hypothesize that a totally non-invasive assessment of aortic compliance may potentially prove a useful surrogate marker of such atherosclerotic risk. 6. Blood pressure-corrected indices of arterial elastic properties based on normotensive models are widely applied in the literature. Our observation that these indices exhibit a considerable blood pressure dependence leads us to urge caution in the use of such corrections, especially in hypertensive patients.

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26

Khasanova, D. R., T. V. Danilova, and Z. K. Latypova. "Epilepsy in patients with ischemic brain disease." Kazan medical journal 94, no. 2 (April 15, 2013): 235–39. http://dx.doi.org/10.17816/kmj1595.

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Epilepsy is one of the most actual social problems in modern neurology and psychiatry. According to the results of the domestic and foreign studies, the risk of developing epilepsy increases with age. The increased rate of nervous system vascular and degenerative diseases as well as brain tumors and head injuries in elderly patients is one of the reasons for it. The review is devoted to the development of epilepsy in adults having an active cerebrovascular disease. Epilepsy is the disease with multiple causative factors. Among the etiological factors of epilepsy development in adults, the predominant place belongs to vascular diseases. The article presents the epidemiological aspects of the problem, the questions of pathophysiology, the variability of epileptic syndromes developing as a result of ischemic brain disease. It describes the characteristics of epileptic process as a result of a vascular lesion. The role of the cerebrovascular reactivity in brain vascular diseases development is described. A place of different research methods (such as electroencephalography, transcranial and extracranial duplex ultrasonography scanning of the major brain vessels, different modes of magnetic resonance imaging, functional magnetic resonance imaging and magnetic resonance spectroscopy) in identifying risk factors for seizures in patients with cerebrovascular pathology is reported. Possible exogenous and endogenous precipitants (cerebral atherosclerotic vascular disease, hypertension, cerebrovascular deregulation, increased convulsive predisposition, the external epileptic triggers, etc.) are described.

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27

Nur, Erfan, Yu-Sok Kim, Jasper Truijen, Eduard J. van Beers, Shyrin C. A. T. Davis, Dees P. Brandjes, Bart J. Biemond, and Johannes J. van Lieshout. "Cerebrovascular reserve capacity is impaired in patients with sickle cell disease." Blood 114, no. 16 (October 15, 2009): 3473–78. http://dx.doi.org/10.1182/blood-2009-05-223859.

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Abstract Sickle cell disease (SCD) is associated with a high incidence of ischemic stroke. SCD is characterized by hemolytic anemia, resulting in reduced nitric oxide-bioavailability, and by impaired cerebrovascular hemodynamics. Cerebrovascular CO2 responsiveness is nitric oxide dependent and has been related to an increased stroke risk in microvascular diseases. We questioned whether cerebrovascular CO2 responsiveness is impaired in SCD and related to hemolytic anemia. Transcranial Doppler-determined mean cerebral blood flow velocity (Vmean), near-infrared spectroscopy-determined cerebral oxygenation, and end-tidal CO2 tension were monitored during normocapnia and hypercapnia in 23 patients and 16 control subjects. Cerebrovascular CO2 responsiveness was quantified as Δ% Vmean and Δμmol/L cerebral oxyhemoglobin, deoxyhemoglobin, and total hemoglobin per mm Hg change in end-tidal CO2 tension. Both ways of measurements revealed lower cerebrovascular CO2 responsiveness in SCD patients versus controls (Vmean, 3.7, 3.1-4.7 vs 5.9, 4.6-6.7 Δ% Vmean per mm Hg, P < .001; oxyhemoglobin, 0.36, 0.14-0.82 vs 0.78, 0.61-1.22 Δμmol/L per mm Hg, P = .025; deoxyhemoglobin, 0.35, 0.14-0.67 vs 0.58, 0.41-0.86 Δμmol/L per mm Hg, P = .033; total-hemoglobin, 0.13, 0.02-0.18 vs 0.23, 0.13-0.38 Δμmol/L per mm Hg, P = .038). Cerebrovascular CO2 responsiveness was not related to markers of hemolytic anemia. In SCD patients, impaired cerebrovascular CO2 responsiveness reflects reduced cerebrovascular reserve capacity, which may play a role in pathophysiology of stroke.

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Johansen, Michelle C., and Rebecca F. Gottesman. "Cerebrovascular Disease and Cognitive Outcome in Patients with Cardiac Disease." Seminars in Neurology 41, no. 04 (April 13, 2021): 463–72. http://dx.doi.org/10.1055/s-0041-1726330.

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AbstractThe pace of understanding cognitive decline and dementia has rapidly accelerated over the past decade, with constantly evolving insights into the vascular contributions to cognitive impairment and dementia (VCID). Notably, more overlap has been discovered in the pathophysiology between what was previously understood to be Alzheimer's disease and VCID, leading to a heightened emphasis on disease prevention through early and aggressive control of vascular risk factors. One particularly vulnerable population may be those with cardiac disease, as they are at risk for cerebrovascular disease, which itself can lead to dementia, and increasing evidence supports cognitive impairment in disease processes such as heart failure and atrial fibrillation, independent of ischemic stroke, suggesting other potential mechanisms. In this article, we review the evidence supporting the relationship between cardiac disease, cerebrovascular disease, and cognitive decline and discuss the ongoing and future research efforts aimed at defining the important relationship between these entities.

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29

TERASAKA, Shunsuke, Satoshi KURODA, Satoshi USHIKOSHI, Masanori NAKAMURA, Ken KAZUMATA, Daina KASHIWAZAKI, Fumiyuki OKAMOTO, Katsuhiko NAKANISHI, and Yoshinobu IWASAKI. "Prophylactic Cerebrovascular Reconstructive Surgery for Occlusive Cerebrovascular Disease in Patients with Cardiac Surgery." Surgery for Cerebral Stroke 35, no. 5 (2007): 335–41. http://dx.doi.org/10.2335/scs.35.335.

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30

Lin, Kailong, Liusheng Chen, Yang Wang, Yeqiang Xu, Guanliang Wang, Hongfang Li, Yicheng Pan, Lichun Ma, and Siyi He. "Endovascular treatment of cerebrovascular stenosis with stent for patients with ischemic cerebrovascular disease." Medicine 99, no. 47 (November 20, 2020): e23313. http://dx.doi.org/10.1097/md.0000000000023313.

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31

Nakajima, Kazuo, Masahiko Ichinose, and Shin'ichi Takada. "Ischemic Cerebrovascular Disease in Patients with Atrial Fibrillation." Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 32, no. 7 (1995): 497–502. http://dx.doi.org/10.3143/geriatrics.32.497.

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32

Shibazaki, Kensaku, Kazumi Kimura, Junichi Uemura, Kenichiro Sakai, Yuki Sakamoto, and Shuichi Fujii. "Sleep-disordered breathing in patients with cerebrovascular disease." Nosotchu 33, no. 5 (2011): 488–94. http://dx.doi.org/10.3995/jstroke.33.488.

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33

Perju-Dumbrava, L., Muntean ML, and Muresanu DF. "Cerebrovascular Profile Assessment in Parkinson`s Disease Patients." CNS & Neurological Disorders - Drug Targets 999, no. 999 (September 1, 2013): 71–72. http://dx.doi.org/10.2174/18715273113129990107.

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34

Tanaka, Hisashi, Akio Takeda, and Sawao Ishikawa. "Anosognosia and Somatoparaphrenia in Patients with Cerebrovascular Disease." Higher Brain Function Research 15, no. 2 (1995): 192–97. http://dx.doi.org/10.2496/apr.15.192.

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35

Nielson, Christopher, and Richard M. Fleming. "Blood Glucose and Cerebrovascular Disease in Nondiabetic Patients." Angiology 58, no. 5 (September 28, 2007): 625–29. http://dx.doi.org/10.1177/0003319707303695.

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36

Camargo, Carlos Henrique Ferreira, Eduardo Antunes Martins, Marcos Christiano Lange, Henrique Alvaro Hoffmann, Jissa Jeanete Luciano, Marcelo Rezende Young Blood, Marcelo Derbli Schafranski, Marcelo Machado Ferro, and Edmar Miyoshi. "Abnormal Cerebrovascular Reactivity in Patients with Parkinson’s Disease." Parkinson's Disease 2015 (2015): 1–5. http://dx.doi.org/10.1155/2015/523041.

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Анотація:

Background. Orthostatic hypotension (OH) is an important nonmotor manifestation of Parkinson’s disease (PD). Changes in cerebrovascular reactivity may contribute to this manifestation and can be monitored using transcranial Doppler.Objective. To identify possible changes in cerebrovascular reactivity in patients with OH.Methods. Twenty-two individuals were selected and divided into three groups: with and without OH and controls. Transcranial Doppler was used to assess basal mean blood flow velocity, postapnea mean blood flow velocity, percentage increase in mean blood flow velocity, and cerebrovascular reactivity as measured by the breath-holding index.Results. PD patients had lower values of basal velocity (p=0.019), postapnea velocity (p=0.0015), percentage increase in velocity (p=0.039), and breath-holding index (p=0.04) than the controls. Patients with OH had higher values of basal velocity (p=0.09) and postapnea velocity (p=0.19) but lower values of percentage increase in velocity (p=0.22) and breath-holding index (p=0.32) than patients without OH.Conclusions. PD patients present with abnormalities in a compensatory mechanism that regulates cerebral blood flow. OH could be an indicator of these abnormalities.

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37

Silvestrini, M., M. Matteis, G. Bernardi, A. Pietroiusti, and A. Galante. "Leukocyte aggregation in patients with chronic cerebrovascular disease." Acta Neurologica Scandinavica 89, no. 3 (January 29, 2009): 233–34. http://dx.doi.org/10.1111/j.1600-0404.1994.tb01669.x.

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38

Khadjooi, Kayvan, Deepak Bhatia, and John Paterson. "P0217 DRIVING ADVICE IN PATIENTS WITH CEREBROVASCULAR DISEASE." European Journal of Internal Medicine 20 (May 2009): S78. http://dx.doi.org/10.1016/s0953-6205(09)60237-5.

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39

Prati, P., M. Casaroli, C. Vinci, and I. Pittaro. "Secondary prevention in patients with cerebrovascular ischaemic disease." Italian Journal of Neurological Sciences 19, S1 (October 1998): S43—S47. http://dx.doi.org/10.1007/bf00713886.

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40

Moussouttas, M., L. Aguilar, K. Fuentes, B. Anyanwu, H. Manassarians, N. Papamitsakis, Q. Shi, and P. Visintainer. "Cerebrovascular disease among patients from the Indian subcontinent." Neurology 67, no. 5 (September 11, 2006): 894–96. http://dx.doi.org/10.1212/01.wnl.0000233923.63869.8c.

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41

Blackburn, Patricia Anna, and Peter Decalmer. "Is ect safe in patients with cerebrovascular disease?" International Journal of Geriatric Psychiatry 9, no. 9 (September 1994): 757–61. http://dx.doi.org/10.1002/gps.930090911.

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42

Polonara, G., J. Bove, L. Regnicolo, N. Herber, E. Cesaroni, and N. Zamponi. "Paediatric Cerebrovascular Disease: Neuroradiological Diagnosis." Rivista di Neuroradiologia 18, no. 3 (June 2005): 304–14. http://dx.doi.org/10.1177/197140090501800306.

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Анотація:

The low incidence (2.6 cases in 100,000) of cerebrovascular disease in paediatric patients compared with the adult population makes it a diagnostic challenge. Etiological factors have changed over time: whereas in the past bacterial meningitis was the most frequent cause, heart disease, haematological disorders, vasculopathy and viral infections have now become the most common. Haemorrhagic stroke is most frequently due to arteriovenous malformations (AVMs), cavernous angioma, haematological disorders and intracranial aneurysms. Traumatic or fibrodyplastic arterial thrombosis is extremely rare. Venous thrombosis most commonly affects the upper sagittal sinus. In two thirds of cases the cause of stroke remains unknown. For years, symptoms of acute CNS deficits have been studied with computed tomography (CT), especially to rule out haemorrhage. To avoid exposing paediatric patients to ionizing radiation, magnetic resonance imaging (MRI), more sensitive and specific for the identification of acute ischaemic stroke, is currently the first-line diagnostic technique. In particular, diffusion-weighted sequences are capable of early identification of ischaemic areas. Association with perfusion techniques will define the areas at high risk of further damage and to attempt to estimate the final volume of the lesion. MR spectroscopy contributes to the characterization of ischaemic lesions. MR angiography (MRA) has proved to be a noninvasive technique with the same diagnostic effectiveness as conventional angiography for dissections, transient cerebral arteriopathy and moyamoya. The cervical arteries are studied using contrast-enhanced sequences. Conventional angiography remains the technique of choice for the study of small vessels disease and AVMs.

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43

Virtanen, Juha, Markus Varpela, Fausto Biancari, Juho Jalkanen, and Harri Hakovirta. "Association between anatomical distribution of symptomatic peripheral artery disease and cerebrovascular disease." Vascular 28, no. 3 (January 24, 2020): 295–300. http://dx.doi.org/10.1177/1708538119893825.

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Aim Peripheral arterial disease is frequently associated with significant atherosclerosis of other vascular beds. The aim of the present study was to investigate a possible association between peripheral arterial disease segment-specific disease burden and cerebrovascular disease. Methods Two-hundred and twenty-six patients with clinically symptomatic peripheral arterial disease from the prospective PureASO registry were followed up after revascularization. The breadth of peripheral arterial disease was quantified at the time patients entered the study. The segment-specific peripheral arterial disease burden was correlated to cerebrovascular disease and imaging findings during a five-year follow-up. Results At five years, cerebrovascular disease-free survival after lower limb revascularization was 31%. Patients with peripheral arterial disease involving the crural arteries had significantly more ischemic degenerative changes at brain imaging ( p = 0.031), whereas patients with aorto-iliac and femoropopliteal segment peripheral arterial disease had more significant (>50% uni- or bilaterally) internal carotid artery stenosis compared to patients with crural peripheral arterial disease ( p = 0.006). According to Cox regression analyses, crural arteries burden was associated with a significantly increased risk of mortality (adjusted HR 2.07, CI 95% 1.12–3.28, p = 0.021) and cerebrovascular events (adjusted HR 1.97, CI 95% 1.19–3.26, p = 0.008). Conclusions Present results suggest that atherosclerosis burden at different lower limb artery segments is associated with defined cerebrovascular disease. This further suggests that risk factors and pathophysiological mechanisms are congruent across particular vascular beds.

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44

Harriott, Andrea M., Eli Zimmerman, Aneesh B. Singhal, Michael R. Jaff, Mark E. Lindsay, and Guy A. Rordorf. "Cerebrovascular fibromuscular dysplasia." Neurology: Clinical Practice 7, no. 3 (January 16, 2017): 225–36. http://dx.doi.org/10.1212/cpj.0000000000000339.

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AbstractBackground:Fibromuscular dysplasia (FMD) is a rare noninflammatory, nonatherosclerotic arteriopathy of medium-sized arteries affecting up to 7% of the population. The disease can affect any artery but commonly affects renal, extracranial carotid, and vertebral arteries. The epidemiology and natural course of cerebrovascular FMD is unknown and requires further investigation.Methods:We present demographic and outcomes data on a case series of 81 patients with cerebrovascular FMD from Massachusetts General Hospital presenting between 2011 and 2015 followed by a review of the peer-reviewed literature.Results:Patients were a median age of 53 years (±12 SD) and the majority were women. Approximately 50% had a history of tobacco use and more than two-thirds had hypertension. Most patients were on monoplatelet therapy with aspirin; during follow-up, 7 of 67 had progressive disease or additional symptoms. One of 67 patients had a cerebrovascular event: TIA. There were 5 of 67 who had noncerebrovascular events or disease progression and 1 death of unclear cause.Conclusions:Cerebrovascular FMD may present with myriad symptoms. Our data support that patients with FMD with symptomatic disease have a low rate of recurrent symptoms or disease progression and can be managed conservatively with stroke risk modification, antiplatelet agents, surveillance imaging, and counseling.

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45

Smith, Grace L., Benjamin D. Smith, Thomas A. Buchholz, Sharon H. Giordano, Adam S. Garden, Wendy A. Woodward, Harlan M. Krumholz, Randal S. Weber, K. Kian Ang, and David I. Rosenthal. "Cerebrovascular Disease Risk in Older Head and Neck Cancer Patients After Radiotherapy." Journal of Clinical Oncology 26, no. 31 (November 1, 2008): 5119–25. http://dx.doi.org/10.1200/jco.2008.16.6546.

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Purpose Cerebrovascular disease is common in head and neck cancer patients, but it is unknown whether radiotherapy increases the cerebrovascular disease risk in this population. Patients and Methods We identified 6,862 patients (age > 65 years) from the Surveillance, Epidemiology, and End Results (SEER) –Medicare cohort diagnosed with nonmetastatic head and neck cancer between 1992 and 2002. Using proportional hazards regression, we compared risk of cerebrovascular events (stroke, carotid revascularization, or stroke death) after treatment with radiotherapy alone, surgery plus radiotherapy, or surgery alone. To further validate whether treatment groups had equivalent baseline risk of vascular disease, we compared the risks of developing a control diagnosis, cardiac events (myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, or cardiac death). Unlike cerebrovascular risk, no difference in cardiac risk was hypothesized. Results Mean age was 76 ± 7 years. Ten-year incidence of cerebrovascular events was 34% in patients treated with radiotherapy alone compared with 25% in patients treated with surgery plus radiotherapy and 26% in patients treated with surgery alone (P < .001). After adjusting for covariates, patients treated with radiotherapy alone had increased cerebrovascular risk compared with surgery plus radiotherapy (hazard ratio [HR] = 1.42; 95% CI, 1.14 to 1.77) and surgery alone (HR = 1.50; 95% CI, 1.18 to 1.90). However, no difference was found for surgery plus radiotherapy versus surgery alone (P = .60). As expected, patients treated with radiotherapy alone had no increased cardiac risk compared with the other treatment groups (P = .63 and P = .81). Conclusion Definitive radiotherapy for head and neck cancer, but not postoperative radiotherapy, was associated with excess cerebrovascular disease risk in older patients.

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46

Mustafa, ElrayahM, and RababI Elhassan. "Carotid artery disease in Sudanese diabetic patients asymptomatic for cerebrovascular disease." Sudan Medical Monitor 8, no. 3 (2013): 156. http://dx.doi.org/10.4103/1858-5000.132610.

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47

Green, Richard M. "Coronary artery disease in patients with cerebrovascular disease: A prospective study." Journal of Vascular Surgery 3, no. 6 (June 1986): 942. http://dx.doi.org/10.1016/0741-5214(86)90443-x.

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48

Boon, Agnita J. W., Joseph T. J. Tans, Ernst J. Delwel, Saskia M. Egeler-Peerdeman, Patrick W. Hanlo, Hans A. L. Wurzer, and Jo Hermans. "Dutch Normal-Pressure Hydrocephalus Study: the role of cerebrovascular disease." Journal of Neurosurgery 90, no. 2 (February 1999): 221–26. http://dx.doi.org/10.3171/jns.1999.90.2.0221.

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Object. This study was conducted to determine the prevalence of cerebrovascular disease and its risk factors among patients with normal-pressure hydrocephalus (NPH) and to assess the influence of these factors on the outcome of shunt placement.Methods. A cohort of 101 patients with NPH underwent shunt placement and was followed for 1 year. Gait disturbance and dementia were quantified using an NPH scale and handicap was determined using a modified Rankin scale (mRS). Primary outcome measures consisted of the differences between preoperative and last NPH scale and mRS scores. The presence of risk factors such as hypertension, diabetes mellitus, cardiac disease, peripheral vascular disease, male gender, and advancing age was recorded. Cerebrovascular disease was defined as a history of stroke or a computerized tomography (CT) scan revealing infarcts or moderate-to-severe white matter hypodense lesions.The prevalence of risk factors for cerebrovascular disease was higher in the 45 patients with cerebrovascular disease than the 56 without it. Risk factors did not influence outcome after shunt placement. Intent-to-treat analysis revealed that the mean improvement in the various scales was significantly less for patients with a history of stroke (14 patients), CT scans revealing infarctions (13), or white matter hypodense lesions (32 patients) than for those without cerebrovascular disease. The proportion of patients who responded to shunt placement was also significantly lower among patients with than those without cerebrovascular disease (p = 0.02).Conclusions. The authors identified a subgroup of patients with NPH and cerebrovascular disease who showed disappointing results after shunt placement. Cerebrovascular disease was an important predictor of poor outcome.

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49

Gravlee, Glenn P., Raymond C. Roy, David A. Stump, Allen S. Hudspeth, Anne T. Rogers, and Donald S. Prough. "Regional cerebrovascular reactivity to carbon dioxide during cardiopulmonary bypass in patients with cerebrovascular disease." Journal of Thoracic and Cardiovascular Surgery 99, no. 6 (June 1990): 1022–29. http://dx.doi.org/10.1016/s0022-5223(20)31458-6.

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50

Lin, Chien-Heng, Jung-Nien Lai, Inn-Chi Lee, I.-Ching Chou, Wei-De Lin, Mei-Chen Lin, and Syuan-Yu Hong. "Kawasaki Disease May Increase the Risk of Subsequent Cerebrovascular Disease." Stroke 53, no. 4 (April 2022): 1256–62. http://dx.doi.org/10.1161/strokeaha.120.032953.

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Background: Previous epidemiological investigations examining the association between Kawasaki disease (KD) and cerebrovascular disease have had conflicting results. We analyzed the association between KD and cerebrovascular disease by conducting a population-based retrospective cohort study designed to investigate the hypothesis that KD could be a risk factor for subsequent cerebrovascular disease. Methods: From the National Health Insurance Research Database of Taiwan, the data of children (aged 0–18 years old) with KD (n=8467) were collected. Starting with the first year of study observation (referred to as the baseline year), data was collected for each child with KD, and 4 non-KD patients matched for sex, urbanization level of residence, and parental occupation were randomly selected to form the non-KD cohort (n=33 868) for our analysis. For the period from January 1, 2000, to December 31, 2012, we calculated the follow-up person-years for each patient, which is the time from the index date to the diagnosis of cerebrovascular disease, death, or the end of 2012. Furthermore, we compared the incidence, the incidence rate ratio, and the 95% CI of cerebrovascular disease between the KD and non-KD cohorts. Results: The overall cerebrovascular disease incidence rate was found to be 3.19-fold higher, which is significantly higher, in the KD cohort than in the non-KD cohort (14.73 versus 4.62 per 100 000 person-years), and the overall risk of cerebrovascular disease remained higher in the KD cohort (adjusted hazard ratio, 3.16 [95% CI, 1.46–6.85]). Furthermore, children aged <5 years showed a significantly higher risk of subsequent cerebrovascular disease in the KD cohort (adjusted hazard ratio, 3.14 [95% CI, 1.43–6.92]). Conclusions: This nationwide retrospective cohort study shows that KD may increase the risk of subsequent cerebrovascular disease, especially in those with KD aged <5 years old.

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