| Towards Understanding the Cause of Stroke in Young Adults Utilising a New Stroke Classification System (A-S-C-O). | |
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MedLine Citation:
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PMID: 22179549 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Background: Stroke in younger people is relatively common and frequently unexplained. While understanding of the causes of young stroke has improved, there remains uncertainty over the role of low-risk lesions such as a patent foramen ovale (PFO). The TOAST criteria are often used to describe stroke aetiology, but in younger people in whom PFOs are frequent, there is a very high proportion of cases attributed to cardiac embolism. The impact of using the newer A-S-C-O criteria on stroke aetiology was investigated. Methods: Consecutive patients with ischaemic stroke were investigated and categorised by the TOAST and ASCO1 criteria. Stroke aetiology was presented and compared by the different classification systems. Results: Of the 106 ischaemic stroke cases, by TOAST 6% were 'large artery atheroma', 11% 'small vessel occlusion', 28% 'cardioembolic', 22% 'other determined cause' and 33% 'undetermined cause'. The vascular territory and associated causes are presented. With the ASCO1 criteria, there were more cases of unclassified stroke (51.9 vs. 34.0%; p < 0.001) and fewer cases of cardiac embolism. Kappa ranged from 0.5 for 'undetermined aetiology' to 1.0 for both 'large artery atheroma' and 'other determined aetiology'. Younger cases (<45 years) were less likely to be either 'large artery atheroma' or 'small vessel occlusion'. Conclusion: Using the ASCO criteria, more patients fall into the undetermined group which more accurately reflects our current uncertainty regarding the pathogenic relevance of PFOs in this age group. |
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Authors:
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P E Cotter; M Belham; P J Martin |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-12-14 |
Journal Detail:
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Title: Cerebrovascular diseases (Basel, Switzerland) Volume: 33 ISSN: 1421-9786 ISO Abbreviation: - Publication Date: 2011 Dec |
Date Detail:
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Created Date: 2011-12-19 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9100851 Medline TA: Cerebrovasc Dis Country: - |
Other Details:
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Languages: ENG Pagination: 123-127 Citation Subset: - |
Copyright Information:
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Copyright © 2011 S. Karger AG, Basel. |
Affiliation:
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Department of Medicine, University of Cambridge, Cambridge, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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