Strong family history of stroke. What could it be?

[cool c]

Hey guys. I have what I think is an interesting question for y'all. So I have a strong family history of early age strokes in my family (in 40s) from my dad's side. So here's the family history: my great grandfather, my grandfather, my dad's 2 uncles, and finally my dad. They've all had rather early age strokes, but I haven't been able to find any reasons as to this strong family history. Naturally, I am worried because this could affect me sometime soon.

Unfortunately, I don't really know what kind of workups they've had to try to pinpoint a cause. I am not sure if the strokes have been ischemic or hemorrhagic (my dad's was hemorrhagic). I don't think it's hyperlipidemia as my father's cholestrol levels have alwayz been close to normal without any medication. Some of them had HTN, but 40s seems too early for this to be HTN related and why would HTN only cause strokes without heart disease or other end organ damages? As far as I know there's no thrombophilia history and again why would throbophillia only cause strokes and not MIs or clots in other parts of the body. I can't really think of other pertinent things to mention, but if you guys have other questions, let me know.

Basically that's it, What's on your differential diagnosis???

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[hcrunner82]

I'm only a student so I'm sure the true neurologists will come up with a better differential but what about a berry aneurysm linked to either polycystic kidney disease or a connective tissue disorder???

 

[typhoonegator]

Interesting topic. Unfortunately, personal questions like this are best posed to your personal physician. This forum is not well-equipped to handle these sorts of queries.

The etiology of the strokes in your family could be for many different reasons, and you deserve better than the pure speculation which results from these sorts of threads.

 

[Farmer Jane]

I have a very similar family history and my physician wants me to see a neurologist and have an MRI to look for lurking aneurysms. I'm not quite *there* yet, but I'm working on it. I agree with the above poster that you should discuss it with your physician.

 

[neurologist]

Any family history of migraine? CADASIL is definitely on the list. Although your dad's "hemorrhagic" stroke doesn't completely fit . . . maybe it was ischemic with hemorrhagic conversion?

http://en.wikipedia.org/wiki/CADASIL

 

[cool c]

Thanks everyone. I completely agree with some of your advice. I do plan on posing this question to my family doctor. I jus haven't seen my family doctor in years. Being healthy in ur 20s means that I really haven't seen my family doctor. I just posed this question on this forum cause I thought it'd be interesting to hear people's reply and sort of stimulate my own mind.

Berry aneurysm is a good thought but I thought that caused subarachnoid bleeds. I didn't know it had intraparenchymal hemorrhages or ischemia associated with it. Correct me if I am wrong however. And there's no history of PKD or CTDs.

CADASIL is good thought although no family history of migraines or subcortical dementia. I have entertained the possibility of my dad's ischemic strokes having secondarily converted to hemorrhagic, which obviously would fit better with this diagnosis. Would be sad however knowing that there's no treatment. Lifelong anticoagulation is a horrible way to live, although I guess it beats morbidity and mortality of a stroke.

 

[DarthNeurology]

Thanks everyone. I completely agree with some of your advice. I do plan on posing this question to my family doctor. I jus haven't seen my family doctor in years. Being healthy in ur 20s means that I really haven't seen my family doctor. I just posed this question on this forum cause I thought it'd be interesting to hear people's reply and sort of stimulate my own mind.

Berry aneurysm is a good thought but I thought that caused subarachnoid bleeds. I didn't know it had intraparenchymal hemorrhages or ischemia associated with it. Correct me if I am wrong however. And there's no history of PKD or CTDs.

CADASIL is good thought although no family history of migraines or subcortical dementia. I have entertained the possibility of my dad's ischemic strokes having secondarily converted to hemorrhagic, which obviously would fit better with this diagnosis. Would be sad however knowing that there's no treatment. Lifelong anticoagulation is a horrible way to live, although I guess it beats morbidity and mortality of a stroke.

No harm in getting a head MRI/MRA to see what is there, i.e. an aneurysm can clipped or at least followed, what about homocystinemia? This can cause recurrent arterial thrombosis? Your neurologist would probably/should probably initiate a workup for inherited thrombophilias, i.e. Factor V Leidein, Promthrombin mutation, homocysteine levels, . . . I would sure want to know if I had one of these things.There is treatment for all predisposition to strokes, from surgery to bp control to pharmacologic medications. So why would there be no treatment??? Why is Lifelong anticoagulation a horrible way to live? It just means popping a pill, eventually they may have types of anticoagulation where you don't need a protime every 3 months, it is not nearly a pain as hemodialysis or worse, post-stroke and can't talk or swallow food, . . . once that brain tissue is gone there is no way to get it back that is when there is NO treatment, not now!

 

[yaah]

Closing this thread as seeking medical advice on SDN is not permitted. Please consult a physician in these matters.