Hereditary stroke

Hypertension is one of the two principal risk factors of many cardiovascular diseases, such as coronary heart disease (CHD), stroke, and CHF. Individuals are considered hypertensive if their systoHc arterial blood pressure is over 140 mm Hg (18.7 Pa) or their diastoHc arterial blood pressure is over 90 mm Hg (12 Pa). Over 60 million people, or one-third of the adult population in the United States are estimated to be hypertensive (163). About 90% of these patients are classified as primary or essential hypertensive because the etiology of their hypertension is unknown. It is generally agreed that there is a very strong genetic or hereditary component to this disease. 

A broad variety of diseases may cause neuropathic pain. The majority of diseases associated with neuropathic pain involve the peripheral nervous system. These diseases include traumatic injuries hereditary, metabolic, inflammatory or paraneoplastic neuropathies and infections. However, neuropathic pain can also be caused by injuries or disorders affecting the spinal cord or the brain (central neuropathic pain) tumors stroke epilepsy and neurodegenerative disorders [20]. Genetic factors appear to contribute to inter-individual differences in the susceptibility to neuropathic pain. 

The clinical symptoms of mitochondrial diseases are highly varied and include seizures, vomiting, deafness, dementia, stroke-like episodes, and short stature. Although there are many types of mitochondrial disorders, four of the most common types are as follows Kearns-Sayre syndrome, Leber s hereditary optic atrophy, MELAS (mitochondrial encephalopathy, lactic acidosis and stroke-like episodes) and MERRE (myoclonic epilepsy with ragged red fibres). 

L13. Lofberg, H., Grubb, A. O., Nilsson, E. K., Jensson, O., Gudmundsson, G., et al., Immunohis-tochemical characterization of the amyloid deposits and quantitation of pertinent cerebrospinal fluid proteins in hereditary cerebral hemorrhage with amyloidosis. Stroke 18(2), 431-440 (1987). 

Hereditary dyslipidemias such as familial hypercholesterolemia, type II and type IV hyperlipidemia and Tangiers disease predispose to premature large vessel atherosclerosis and hence stroke (Meschia 2003 Hutter et al. 2004). 

Bornebroek M, Westemdorp RGJ, Haan J et al. (1997). Mortality from hereditary cerebral haemorrhage with amyloidosis Dutch type. The impact of sex parental transmission and year of birth. Brain 120 2243-2249 Brott T, Broderick J, Kothari R et al. (1997). Early haemorrhage growth in patients with intracerebral haemorrhage. Stroke 28 1-5 Brown RD, Wiebers DO, Torner JC et al. (1996). Incidence and prevalence of intracranial vascular malformations in Olmsted, County Minnesota 1965 to 1992. Neurology 46 949-952... 

Thrombosis in the dural sinuses or cerebral veins is much less common than cerebral arterial thromboembolism. It causes a variety of clinical syndromes, which often do not resemble stroke (Bousser and Ross Russell 1997). While ischemic arterial stroke and cerebral venous thrombosis share some causes (Southwick et al. 1986), others are specific to cerebral venous thrombosis (Table 29.1). A particularly high index of suspicion is required in women on the oral contraceptive pill (Saadatnia and Tajmirriahi 2007) and in the puerperium. In the past, cerebral venous thrombosis was strongly associated with otitis media and mastoiditis, lateral sinus thrombosis or otitic hydrocephalus, but the most common causes are now pregnancy and the puerperium, which cause 5-20% of the cerebral venous thrombosis in the developed world, the oral contraceptive pill, malignancy, dehydration, inflammatory disorders and hereditary coagulation disorders. No cause is found in around 20% of cases. 

Maher CO, Piepgras DG, Brown Jr RD, Friedman JA, Pollock BE (2001) Cerebrovascular manifestations in 321 cases of hereditary hemorrhagic telangiectasia. Stroke 32 877-882... 

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