Cerebrovascular disorders: nonfasting triglycerides and stroke, silent ischemia and thrombolysis, and pathogenesis of cervical artery dissection

Excerpt

This month we present three clinically relevant articles from the large number of articles published each month in different journals on cerebrovascular disorders. The first article deals with the correlation between nonfasting triglycerides and cholesterol and the risk of ischemic stroke in a general population. This issue has been discussed since the early 1990s without any clear evidence so far due to methodological shortcomings in previous studies. The current long-term epidemiological study clearly shows an increased risk of stroke in patients with higher nonfasting triglycerides; there were sex differences for cholesterol levels: no increased risk in women, but a higher risk in men with cholesterol levels higher than 9.00 mmol/l. The second article deals with the risk of bleeding after thrombolysis in patients with or without recent silent ischemia detected by MRI. Despite its methodological limitations, this study provides evidence that the bleeding risk is not higher in patients who have had a previous silent ischemia. The third article considerably deepens our knowledge of the pathogenesis of spontaneous cervical artery dissection: histopathologically, degenerative changes were found in specimens of superficial temporal arteries in patients with spontaneous cervical artery dissection primarily at the medial/adventitial border, which was associated with neoangiogenesis of capillary vessels and microhematomas. …