Thesis defense Renate Arntz (Donders series 258)

16 February 2017

Promotors: prof. dr. H. De Leeuw, prof. dr. C.J.M. Klijn,
copromotor: dr. E. van Dijk

The long-term risk of vascular disease and epilepsy after stroke in young adults

Incidence of stroke at young age is increasing and during the years after their stroke patients may encounter various complications. Especially for this younger age group, long-term information on the years after the stroke is of utmost importance. However information on long-term prognosis is scarce.

The studies in this thesis investigated the long-term risk of post-stroke epilepsy and the long-term risk of vascular disease after a stroke at young age. In the first part of this thesis we showed that post-stroke epilepsy after a stroke at young age is a common problem. In addition post-stroke epilepsy after a ischemic stroke is associated with a poor outcome in terms of mortality, functional outcome and cognitive performance. In the second part of this thesis we have shown that patients remain at a lifelong risk of developing recurrent vascular events, especially patients with traditional vascular risk factors. In addition the chronic vascular consequences of a young stroke are also shown by the high proportion of patients who develop small vessel disease compared to control subject.

The work in this thesis may be helpful to counsel patients on the course of their disease. In addition as it remains unclear how to treat a patient with a stroke  at young age, the risk estimates of recurrent vascular events may be used to design future intervention studies on start and withdrawal of secondary prevention in these young patients.