Abstract Details

With advances in modern medicine, life expectancy of patients with Down syndrome has reached about 60 years of age.  While noteworthy, this does come with increased risks of medical complications, specifically including increased stroke risk. Causes of stroke in Down syndrome are multiple; in addition to common stroke etiologies, these include:  moyamoya, congenital heart disease, atlanto axial subluxation (predisposing to arterial dissection), hypothyroidism associated hyperlipidemia, hematologic malignancies and their treatments., and cardiovascular complications of obstructive sleep apnea.

Down syndrome is commonly associated with heterogeneous groups of disorders that may result in arterial or venous stroke. We sought to explore our experience at Loyola (LUHS) and describe some of the risk factors leading to stroke among patients with Down syndrome.

A retrospective chart analysis was conducted on Down syndrome patients at LUHS presenting with stroke from 01/01/2010 to 12/31/2021.  We recorded age, gender, race, ethnicity, stroke type and etiologies, medical comorbidities, intracranial location of stroke, NIHSS, modified Rankin (admission and discharge), interventions, hospital complications and disposition

We identified seven stroke patients with Down syndrome for whom full data was available. There were 5 ischemic strokes, 1 central venous sinus thrombosis, and 1 intracerebral hemorrhage. Cardiac abnormalities were the most common medical comorbidity. The 2 most frequent ischemic stroke etiologies were cardiovascular and moyamoya syndromes. Three patients did not survive their strokes,1 went to acute rehab and 3 were discharged home.

This study provides a perspective about  the ongoing complexity of Down syndrome stroke patients in the 21st century.   A comprehensive in-depth approach to explore stroke mechanisms and aggressive stroke risk factor modification of Downs Syndrome patients remains essential.