Nozaki F, Kusunoki T, Kumada T, Shibata M, Fujii T. Risk Factors for Cerebral Infarction in Duchenne Muscular Dystrophy: Review With our 2 Cases. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association 2019;28:2453-2458
BACKGROUND: Although the incidence of cerebral infarction is higher in Duchenne muscular dystrophy (.75 per 100) than in the general population (7.5-11.4 per 100 000), only 18 cases have been reported, and prevention and management guidelines for infarction in this disorder remain lacking.
PATIENTS AND METHODS: We encountered 2 cases of Duchenne muscular dystrophy with cerebral infarction. To clarify risk factors for such infarction in Duchenne muscular dystrophy, we reviewed 20 cases, including our 2 patients.
RESULTS: Age at onset of infarction ranged from 4 to 31 years (n=19). Most patients were 16-21 years old (14 of 19; 73.7%). Eighteen patients (90%) had dilated cardiomyopathy (DCM), showing a higher frequency than in the age-matched general Duchenne muscular dystrophy population. Left ventricular ejection fraction (LVEF) ranged from 10.2% to 42% (median, 20%; n=9). Detectable cardiac thrombus and atrial fibrillation were rare (2 of 17; 11.8%, and 1 of 17; 5.9%, respectively).
CONCLUSIONS: Presence of DCM with low LVEF seems to be the strongest risk factor for cerebral infarction in Duchenne muscular dystrophy.