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The Norwegian Stroke in the Young Study (NOR-SYS): rationale and design.

Fromm A, Thomassen L, Naess H, Meijer R, Eide GE, Kråkenes J, Vedeler CA, Gerdts E, Larsen TH, Kuiper KK, Laxdal E, Russell D, Tatlisumak T, Waje-Andreassen U - BMC Neurol (2013)

Bottom Line: The assumed cause of infarction and the detected risk factors determine the early- and long-term treatment.To date, the study is a single centre study with approximately 400 patients, 250 partners and 350 adult offspring expected to be recruited at our site.Moreover, optimization of diagnostics, prophylaxis and early intervention are major targets with the intention to reduce stroke recurrence and other clinical arterial events, physical disability, cognitive impairment and death.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: Ischemic stroke in young adults is a major health problem being associated with a higher vascular morbidity and mortality compared to controls, and a stroke recurrence rate of 25% during the first decade. The assumed cause of infarction and the detected risk factors determine the early- and long-term treatment. However, for many patients the cause of stroke remains unknown. Risk factor profile and etiology differ in young and elderly ischemic stroke patients, and atherosclerosis is the determined underlying condition in 10 to 15%. However, subclinical atherosclerosis is probably more prevalent and may go unrecognized.

Methods/design: NOR-SYS is a prospective long-term research program. Standardized methods are used for anamnestic, clinical, laboratory, imaging, and ultrasound data collection in ischemic stroke patients aged ≤60 years, their partners and joint adult offspring. The ultrasound protocol includes the assessment of intracranial, carotid and femoral arteries, abdominal aorta, and the estimation of VAT. To date, the study is a single centre study with approximately 400 patients, 250 partners and 350 adult offspring expected to be recruited at our site.

Discussion: NOR-SYS aims to increase our knowledge about heredity and the development of arterial vascular disease in young patients with ischemic stroke and their families. Moreover, optimization of diagnostics, prophylaxis and early intervention are major targets with the intention to reduce stroke recurrence and other clinical arterial events, physical disability, cognitive impairment and death.

No MeSH data available.


Related in: MedlinePlus

Meijer’s Carotid Arc® (publication with written informed consent by the patient).
© Copyright Policy - open-access
Related In: Results  -  Collection

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Figure 3: Meijer’s Carotid Arc® (publication with written informed consent by the patient).

Mentions: b2) IMT-measurements: Vertical markers in a horizontal distance of 10 mm each are used to define the distal CCA, the bifurcation (BIF), and the proximal ICA segment in longitudinal view, using the tip of the flow divider (TFD) as internal landmark for placement of the second vertical marker (Figure 2). The CCA segment is defined 20–10 mm proximally to the TFD, the BIF segment is defined as 10–0 mm proximally to the TFD, and the ICA segment is defined as 0–10 mm distally to the TFD. Intima-media thickness (IMT) is visualized in longitudinal view on the far and, if possible, on the near wall of each segment, to ensure center position of the scan plane in the artery. Meijer’s Carotid Arc® (Figure 3) is used for standardization of the scan angles, performed at 180°, 150°, 120° and 90° in the right CCA segment, and at 180°, 210°, 240°, and 270° in the left CCA segment. IMT-measurements in BIF and ICA segments are bilaterally performed at the angle representing the most significant pathological finding, respectively. All measurements are performed in the enddiastolic phase of the cardiac cycle. Frozen pictures are stored for each measurement. IMT-analysis is performed by Philips QLAB-software after completed examination. IMT measurements are done over a distance of 10 mm for each far wall segment (Figure 2), and are stored as a mean value. In case of irregular IMT or presence of plaques, measurements of the maximum IMT or plaque thickness are additionally performed. Due to updated Mannheim Carotid Intima-Media Thickness Consensus criteria, plaques are defined as focal IMT measurements >1.5 mm [33]. Plaque surface is being evaluated as smooth, irregular or ulcerated.


The Norwegian Stroke in the Young Study (NOR-SYS): rationale and design.

Fromm A, Thomassen L, Naess H, Meijer R, Eide GE, Kråkenes J, Vedeler CA, Gerdts E, Larsen TH, Kuiper KK, Laxdal E, Russell D, Tatlisumak T, Waje-Andreassen U - BMC Neurol (2013)

Meijer’s Carotid Arc® (publication with written informed consent by the patient).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3721997&req=5

Figure 3: Meijer’s Carotid Arc® (publication with written informed consent by the patient).
Mentions: b2) IMT-measurements: Vertical markers in a horizontal distance of 10 mm each are used to define the distal CCA, the bifurcation (BIF), and the proximal ICA segment in longitudinal view, using the tip of the flow divider (TFD) as internal landmark for placement of the second vertical marker (Figure 2). The CCA segment is defined 20–10 mm proximally to the TFD, the BIF segment is defined as 10–0 mm proximally to the TFD, and the ICA segment is defined as 0–10 mm distally to the TFD. Intima-media thickness (IMT) is visualized in longitudinal view on the far and, if possible, on the near wall of each segment, to ensure center position of the scan plane in the artery. Meijer’s Carotid Arc® (Figure 3) is used for standardization of the scan angles, performed at 180°, 150°, 120° and 90° in the right CCA segment, and at 180°, 210°, 240°, and 270° in the left CCA segment. IMT-measurements in BIF and ICA segments are bilaterally performed at the angle representing the most significant pathological finding, respectively. All measurements are performed in the enddiastolic phase of the cardiac cycle. Frozen pictures are stored for each measurement. IMT-analysis is performed by Philips QLAB-software after completed examination. IMT measurements are done over a distance of 10 mm for each far wall segment (Figure 2), and are stored as a mean value. In case of irregular IMT or presence of plaques, measurements of the maximum IMT or plaque thickness are additionally performed. Due to updated Mannheim Carotid Intima-Media Thickness Consensus criteria, plaques are defined as focal IMT measurements >1.5 mm [33]. Plaque surface is being evaluated as smooth, irregular or ulcerated.

Bottom Line: The assumed cause of infarction and the detected risk factors determine the early- and long-term treatment.To date, the study is a single centre study with approximately 400 patients, 250 partners and 350 adult offspring expected to be recruited at our site.Moreover, optimization of diagnostics, prophylaxis and early intervention are major targets with the intention to reduce stroke recurrence and other clinical arterial events, physical disability, cognitive impairment and death.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: Ischemic stroke in young adults is a major health problem being associated with a higher vascular morbidity and mortality compared to controls, and a stroke recurrence rate of 25% during the first decade. The assumed cause of infarction and the detected risk factors determine the early- and long-term treatment. However, for many patients the cause of stroke remains unknown. Risk factor profile and etiology differ in young and elderly ischemic stroke patients, and atherosclerosis is the determined underlying condition in 10 to 15%. However, subclinical atherosclerosis is probably more prevalent and may go unrecognized.

Methods/design: NOR-SYS is a prospective long-term research program. Standardized methods are used for anamnestic, clinical, laboratory, imaging, and ultrasound data collection in ischemic stroke patients aged ≤60 years, their partners and joint adult offspring. The ultrasound protocol includes the assessment of intracranial, carotid and femoral arteries, abdominal aorta, and the estimation of VAT. To date, the study is a single centre study with approximately 400 patients, 250 partners and 350 adult offspring expected to be recruited at our site.

Discussion: NOR-SYS aims to increase our knowledge about heredity and the development of arterial vascular disease in young patients with ischemic stroke and their families. Moreover, optimization of diagnostics, prophylaxis and early intervention are major targets with the intention to reduce stroke recurrence and other clinical arterial events, physical disability, cognitive impairment and death.

No MeSH data available.


Related in: MedlinePlus