Core Concepts
Structural bone anomalies can cause recurrent strokes, necessitating unique diagnostic and treatment approaches.
Abstract
In a new case series, the presence of structural bone and cartilage anomalies causing mechanical stress to brain-supplying arteries is identified as a potential cause of recurrent ischemic strokes. The study emphasizes the importance of considering "bony strokes" in patients with recurrent strokes in the same vascular territory. Diagnosis involves a combination of imaging techniques, including CT, MRI, angiography, and sonography. Treatment options range from conservative measures to surgical interventions, with a focus on eliminating the mechanical stressor. The study highlights the need for further research and prospective trials to optimize patient care and prevent future stroke recurrences.
Unusual cause of ischemic stroke: bone and cartilage anomalies stress brain-supplying arteries.
Diagnosis based on imaging techniques: CT, MRI, angiography, and sonography.
Treatment options include conservative measures, endovascular stenting, and surgical interventions.
Emphasis on eliminating the mechanical stressor to prevent recurrent strokes.
Call for future prospective trials to enhance patient care and outcomes.
Stats
"In patients with recurrent strokes in one vascular territory the presence of a symptomatic anatomic bone or cartilage anomaly may be considered as a differential diagnosis after sufficient exclusion of competing etiologies of an ischemic stroke."
"The study was published online April 13 in the journal Stroke."
"The authors describe the identification and therapeutic workup of six patients with a bony stroke among 4200 patients with ischemic stroke treated from January 2017 to March 2022 at their comprehensive stroke care center, constituting an incidence of 0.14%."
"Compared with annual stroke rates in atrial fibrillation patients, stroke recurrence in this patient cohort ahead of definite treatment was high (cumulative 2.14 strokes per year)."
Quotes
"Due to the possibly high risk of stroke recurrence and potentially causative treatment options, bony strokes seem to be highly relevant for clinical practice."
"Our case series aims to raise awareness for the rare entity of bony strokes, emphasizing the necessity to evaluate structural bone or cartilage lesions as a possible cause of ischemic stroke in patients with stroke recurrence of unknown cause in one vascular territory."