Thesis defense Nathalie Synhaeve (Donders series 227)

28 September 2016

Promotor: prof. dr. K. Klijn, copromotors: dr. F. de Leeuw, dr. P. de Kort

Determinants of long-term functional prognosis after stroke in young adults

The long-term outcome in young stroke patients is not favourable. This is in contrast with the general opinion in neurologists, which is based on studies describing lower short-term mortality rates in young stroke patients compared to older patients. A substantial proportion of patients, even in the long run after stroke (on average 14 years after stroke), stays dependent in daily living, despite their young age. This especially holds true for women and patients with severe neurological deficits at admission. Fatigue and depression after stroke are associated with a lower quality of life. Therefore, it is important that health care professionals actively assess the presence of these symptoms. Unexpectedly, in contrast, the effect of post-stroke cognitive disorders on the daily life after a stroke at young age is less clear. A new, preliminary insight is the association between kidney dysfunction and the occurrence of recurrent strokes after a young stroke.

The results of these studies enable health care professionals to give patients and their relatives more accurate information on the long-term functional prognosis after a stroke at young age. More studies are needed to develop personalized predictive models to counsel young stroke patients about their future perspectives and to unravel the pathophysiological mechanisms that are responsible for the influence of specific determinants of prognosis, such as the female sex and kidney dysfunction.