Diagnostic Yield of High-Resolution Vessel Wall Magnetic Resonance Imaging in the Evaluation of Young Stroke Patients

Naaem Simaan, Tamer Jubeh, Fatma Shalabi, Hamza Jubran, Issa Metanis, Yoav Parag, Yoel Schwartzman, Jad Magadlla, John M. Gomori, Karine Wiegler Beiruti, Jose E. Cohen, Ronen Leker

Research output: Contribution to journalArticlepeer-review

Abstract

(1) Background: The mechanism responsible for stroke in patients younger than 50 often remains unknown. This study was designed to assess whether high-resolution intracranial vessel wall MR imaging (icVWI) may be instrumental in determining stroke cause. (2) Methods: Young stroke patients with and without an identified cause of stroke despite an exhaustive investigation were prospectively included. Patients who underwent icVWI were compared to those who did not. We next compared patients with and without intracranial vulnerable plaques on icVWI. (3) Results: Overall, 47 young stroke patients were identified over the span of 2 years and included in this study. Of those, 20 (42%) underwent intracranial icVWI. Cancer prevalence was higher among patients who did not have an icVWI study (19% vs. 0% p = 0.042) but there were no other significant differences between patients who had an icVWI study and those who did not have an icVWI. Among patients who had an icVWI, 11 (55%) had vulnerable plaques and the remaining nine studies were negative. Patients with positive icVWI scans had significantly higher stroke severity at admission (mean ± SD NIHSS score 5.5 ± 3.5 vs. 1.7 ± 2.3, p = 0.012). Patients with positive icVWI scans were more often treated with antiplatelets upon discharge (100% vs. 67%, p = 0.038). (4) Conclusions: icVWI can add significant information relevant to stroke pathogenesis and secondary prevention among young stroke patients with a negative exhaustive diagnostic workup.

Original languageEnglish
Article number189
JournalJournal of Clinical Medicine
Volume13
Issue number1
DOIs
StatePublished - 29 Dec 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Funding

This study was supported in part by an unrestricted grant from the Peritz and Chantal Scheinberg Cerebrovascular Research Fund.

FundersFunder number
Peritz and Chantal Scheinberg Cerebrovascular Research Fund

    Keywords

    • MRI
    • stroke
    • vessel wall
    • young patients

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