Radiological pattern in cryptogenic stroke/TIA patients with and without thrombophilia.

BACKGROUND

The radiological pattern of stroke patients with thrombophilia is unknown. Our aim is to compare the MRI radiological pattern of silent and acute lesions in cryptogenic stroke/TIA patients under 60 years of age with and without thrombophilia.

METHODS

Cryptogenic stroke/TIA patients under 60 years of age hospitalized at our Stroke Unit during four years were consecutively included. Thrombophilia screening was performed at 3 months after stroke and verified 12 weeks later. The follow-up was performed at 3, 12 and 24 months. Radiological pattern was assessed with the Fazekas and van Swieten scales.

RESULTS

During four years, 185 cryptogenic stroke/TIA patients under 60 years of age were included; mean age was 51 years, 61% were female, with a follow-up of 22±3.2 months. Thrombophilia was detected in 20% of patients. We detected a significant increase of previous vascular events (29.7% vs 7.5%, p=.01) as well as lower hypercholesterolemia (27% vs 62.5% p=.003) in the thrombophilia group, without significant differences in other vascular risk factors or vascular recurrence during follow-up. Regarding the acute lesion, we did not detect significant differences between groups. The radiological pattern of silent lesions showed that the thrombophilia group presented more large confluent lesions (39.1% vs 19.2%, p=.02) with greater sparing of the anterior territory (0% vs 30%, p=.01).

CONCLUSIONS

Our data suggest a characteristic radiological pattern of silent lesions in cryptogenic stroke/TIA patients with thrombophilia, with more confluent lesions and less involvement of the anterior territory.