%0 Journal Article
%T Importance and repercussions of renal and cardiovascular pathology on stroke in young adults: an anatomopathologic study of 52 clinical necropsies
%A Arismendi-Morillo
%A Gabriel
%A Fern¨˘ndez-Abreu
%A Mary
%A Cardozo-Duran
%A Jos¨¦
%A Vilchez-Barrios
%A Gustavo
%J Clinics
%D 2008
%I Faculdade de Medicina / USP
%R 10.1590/S1807-59322008000100004
%X introduction: stroke in young adults has seldom been studied in a necropsy series. the objective of the present clinical necropsy-based investigation was to analyze stroke and its relationship with cardiovascular and renal pathology in young adults. materials and methods:the protocols of 52 clinical necropsies with diagnoses of stroke in patients aged 18 - 49 years, performed between the years 1990-2006, were reviewed. results: hemorrhagic stroke was diagnosed in 36 patients (69.3%), whereas the remaining 16 (30.7%) had ischemic stroke. hypertensive cardiopathy was evident in 88.4% of the cases. chronic renal pathology, directly or indirectly related to hypertension, was observed in 55.7% of the patients. ischemic stroke as a result of occlusive atherosclerotic disease was seen in 50% of cases. cardiogenic emboli were found in 25% of the cadavers. hemorrhagic stroke was associated with hypertension in 43% of the cases, with ruptured vascular malformations in 29%, and coagulopathies in 17% of the cases. hypertensive cardiopathy was present in patients with either ischemic or hemorrhagic stroke (81.2% and 91.6%, respectively). the most frequently observed renal ailments were chronic pyelonephritis (23%) and nephrosclerosis (21.1%). these were associated with ischemic stroke in 43.7%, and 12.5% of the cases, respectively, and with 13.8% and 25% of the hemorrhagic stroke cases. discussion: hypertensive cardiopathy, occlusive atherosclerotic disease, chronic pyelonephritis and nephrosclerosis are among the pathophysiologycal mechanisms that apparently and eventually interact to induce a significant number of cases of stroke in young adults. a chronic systemic inflammatory state appears to be an important related condition because it possibly constitutes an accelerant of the pathophysiologycal process.
%K inflammation
%K atherosclerosis
%K chronic kidney disease
%K hypertension
%K hypertensive cardiopathy.
%U http://www.scielo.br/scielo.php?script=sci_abstract&pid=S1807-59322008000100004&lng=en&nrm=iso&tlng=en