22. European Stroke Conference 437 Behavioral disorders and post-stroke dementia Cognitive impairment as single manifestation of bilateral carotid artery dissection S. TUTA1, C. Popa2 UMF Carol Davila Bucharest; Institute of Cerebrovascular Diseases Bucharest, Bucharest, ROMANIA1, Institute of Cerebrovascular Diseases Bucharest, Bucharest, ROMANIA2 Background. Cognitive dysfunction in patients with bilateral carotid stenosis or occlusion is much more rare in those without stroke history. We present a 63-years old patient with bilateral internal carotid artery (ICA) dissection and cognitive dysfunction as reason for hospital presentation. Method. The patient was admitted for memory complains and a feeling of decreasing attention span and professional skills. In hospital patient tests revealed reduction of scores for working and visual memory (backward digit span, pattern recognition memory), sustained attention tests and borderline results in executive functions tests (Hanoï Tower, the Stroop tests, and the Trail-Making Tests A and B). The “7 minutes” screening tests for Alzheimer disease (Benton’s temporal orientation, Grober and Buschke enhanced clued recall, verbal fluency and clock drawing tests) were in normal ranges. The cerebral MRI didn’t showed an atrophy of hyppocampal area, but small areas of FLAIR hyper-intensities with arterial borderline distribution between ACA and MCA territory were present in both hemispheres. The internal carotid arteries were absent on MRA and the cervical ultrasound exam-ination didn’t proved significant atheroma lesions, but a high resistance flow pattern was present in ICA bulb on both sides. The DSA revealed the presence of “string sign” in both post bulbar ICA and extensive development of external carotid branches and anastomosis of pial arteries branches of pos-terior cerebral artery with MCA and ACA pial branches. The patient had no history of trauma, head-ache, Horner sign was absent, but questioned again he recalled an episode of 2-3 minutes of speech disturbance 10 months ago, which subsided after recline position. Results and Conclusion. We recommend at any age a careful arterial multimodal examination in “non Alzheimer cognitive impairment” without vascular risk factors, to rule out a (bilateral) ICA dissection with chronic hypoperfusion and silent strokes. 518 © 2013 S. Karger AG, Basel Scientific Programme 438 Behavioral disorders and post-stroke dementia Vascular risk factors and poststroke dementia D.V. Račić1, M. Siniša2, Z. Vujković3, V. Đajić4 Clinical Center Banjaluka, Department of neurology, Banjaluka, BOSNIA-HERZEGOVINA1, Clinical Center Banjaluka, Department of neurology, Banjaluka, BOSNIA-HERZEGOVINA2, Clin-ical Center Banjaluka, Department of neurology, Banjaluka, BOSNIA-HERZEGOVINA3, Clinical Center Banjaluka, Department of neurology, Banjaluka, BOSNIA-HERZEGOVINA45 OBJECTIVE: The goal of the present study was to examine a neuroradiological characteristics asso-ciated with poststroke dementia in a series of 463 unselected stroke patients during one year period. METHODS: A standard Stroke Registry was prospectively applied at admission and 3 months after stroke, this protocol included clinical, functional and cognitive assessments, CT and/or MRI exams. After a neuropsychological examination and a interview with a relative, the diagnosis of vascular dementia was made according to NINDS-AIREN criteria. RESULTS: From the 463 patients included in the Stroke Registry, 273 (58,9% of the registry sample and 84% of survivors) were examinated 3 months after stroke. Seventhy-one (26%) cases demon-strated dementia; 22 of them (8,05%) had demonstrated dementia before the stroke. Dementia was unrelated to type (ishaemic/hemorrhagic) of stroke. Among the vascular risk factors atrial fibrillation and previous stroke vere statistically significant. Other risk factors (hypertension,diabetes mellitus, myocardial infarction, hearth failure, high lipid levels, cigarette smoking, alchocol intake) did not reach statisctical significance. CONCLUSION: Dementia is frequent after ischemic or hemorrhagic stroke and is not determined by a single factor. There is limited impact of traditional vascular risc factors.
Karger_ESC London_2013
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