Skip to main content

Advertisement

SpringerLink
Log in

Stroke and Fabry disease

  • Review
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Fabry disease (FD) is a rare inherited disorder of the metabolism, associated with renal, cardiac, and cerebrovascular complications. Ischemic and hemorrhagic stroke in FD present with a similar proportion to that observed in the general population, but usually at an early age. Ischemic stroke may result from cardiac embolism, large and small vessel disease, while hemorrhagic stroke is usually attributed to hypertension. Deposition of glycosphingolipids in endothelial cells results in a specific FD vasculopathy that contributes to the different vascular phenotypes. Neuroimaging features of cerebrovascular involvement in FD include white matter lesions, dolichoectasia, and the “pulvinar sign”, a T1 MRI hyperintensity of the posterior thalamus. The role of enzymatic replacement therapy in the prevention of stroke remains to be established, but its utilization should be considered in FD stroke patients, for prevention of renal and cardiac complications, together with general prevention measures. Enzymatic replacement therapy increased our awareness of FD, underlining the importance of incomplete phenotypes in specific settings such as stroke. An overview of studies on the prevalence of FD in stroke patients is presented. Available data suggest that prevalence of FD is similar to some of the rare causes of stroke usually considered, and that classic features of the disease may be absent or more subtle. Moreover, FD should be considered in both cryptogenic and all-cause stroke. The role of FD in stroke on a multifactorial basis and the identification of a putative “stroke variant” are questions that need to be further elucidated in future studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Fellgiebel A, Müller MJ, Ginsberg L (2006) CNS manifestations of Fabry’s disease. Lancet Neurol 5:791–795

    Article  PubMed  Google Scholar 

  2. Eng CM, Guffon N, Wilcox WR, Germain DP, Lee P, Waldek S, Caplan L, Linthorst GE, Desnick RJ, International Collaborative Fabry Disease Study Group (2001) Safety and efficacy of recombinant human α-galactosidase. A replacement therapy in Fabry’s disease. N Engl J Med 345:9–16

    Article  PubMed  CAS  Google Scholar 

  3. Sims K, Politei J, Banikazemi M, Lee P (2009) Stroke in Fabry disease frequently occurs before diagnosis and in the absence of other clinical events. Natural history data from the Fabry Registry. Stroke 40:788–794

    Article  PubMed  Google Scholar 

  4. Spada M, Pagliardini S, Yasuda M, Tukel T, Thiagarajan G, Sakuraba H, Ponzone A, Desnick RJ (2006) High incidence of later-onset Fabry disease revealed by newborn screening. Am J Hum Genet 79:31–40

    Article  PubMed  CAS  Google Scholar 

  5. Rolfs A, Böttcher T, Zschiesche M, Morris P, Winchester B, Bauer P, Walter U, Mix E, Löhr M, Harzer K, Strauss U, Pahnke J, Grossmann A, Benecke R (2005) Prevalence of Fabry disease in patients with cryptogenic stroke: a prospective study. Lancet 366:1794–1796

    Article  PubMed  Google Scholar 

  6. Brouns R, Sheorajpanday R, Braxel E, Eyskens F, Baker R, Hughes D, Mehta A, Timmerman T, Vincet MF, De Deyn PP (2007) Middleheim Fabry Study (MiFaS): a retrospective Belgian study on the prevalence of Fabry disease in young patients with cryptogenic stroke. Clin Neurol Neurosurg 109:479–484

    Article  PubMed  Google Scholar 

  7. Wozniak MA, Kittner SJ, Tuhrim S, Cole JW, Stern B, Dobbins M, Grace ME, Nazarenko I, Dobrovolny R, McDade E, Desnick RJ (2010) Frequency of unrecognized Fabry disease among young European–American and African–American men with first ischemic stroke. Stroke 41:78–81

    Article  PubMed  Google Scholar 

  8. Baptista MV, Ferreira S, Pinho-E-Melo T, Carvalho M, Cruz VT, Carmona C, Silva FA, Tuna A, Rodrigues M, Ferreira C, Pinto AA, Leitão A, Gabriel JP, Calado S, Oliveira JP, Ferro JM, PORTYSTROKE Investigators (2010) Mutations of the GLA gene in young patients with stroke: the PORTYSTROKE study—screening genetic conditions in Portuguese young stroke patients. Stroke 41:431–436

    Article  PubMed  CAS  Google Scholar 

  9. Brouns R, Thijs V, Eyskens F, Van den Broeck M, Belachew S, Van Broeckhoven C, Redondo P, Hemelsoet D, Fumal A, Jeangette S, Verslegers W, Baker R, Hughes D, De Deyn PP, BeFaS Investigators (2010) Belgian Fabry study: prevalence of Fabry disease in a cohort of 1000 young patients with cerebrovascular disease. Stroke 41:863–868

    Article  PubMed  Google Scholar 

  10. Rombach SM, Twickler TB, Aerts JMFG, Linthorst GE, Wijburg FA, Hollak CEM (2010) Vasculopathy in patients with Fabry disease: current controversies and research directions. Mol Genet Metabol 99:99–108

    Article  CAS  Google Scholar 

  11. Desnick RJ, Ioannou YA, Eng CM (2001) α-Galactosidase A deficiency: Fabry disease. In: Scriver CR, Beaudet AL, Sly WS, Valle D (eds) The metabolic and molecular bases of inherited disease. McGraw-Hill, New York, pp 3733–3774

    Google Scholar 

  12. Zarate YA, Hopkin RJ (2008) Fabry’s disease. Lancet 372:1427–1435

    Article  PubMed  CAS  Google Scholar 

  13. Ramaswami U, Whybra C, Parini R, Pintos-Morell G, Mehta A, Sunder-Plassmann G, Widmer U, Beck M (2006) Clinical manifestations of Fabry disease in children: data from the Fabry Outcome Survey. Acta Paediatr 95:86–92

    Article  PubMed  Google Scholar 

  14. Hopkin RJ, Bissler J, Banikazemi M, Clarke L, Eng CM, Germain DP, Lemay R, Tylki-Szymanska A, Wilcox WR (2008) Characterization of Fabry disease in 352 pediatric patients in the Fabry Registry. Pediatr Res 64:550–555

    Article  PubMed  Google Scholar 

  15. Gold KF, Pastores GM, Botteman MF, Yeh JM, Sweeney S, Aliski W, Pashos CL (2002) Quality of life of patients with Fabry disease. Qual Life Res 11:317–327

    Article  PubMed  CAS  Google Scholar 

  16. Vedder AC, Linthorst GE, van Breemen MJ, Groener JE, Bemelman FJ, Strijland A, Mannens MM, Aerts JM, Hollak CE (2007) The Dutch Fabry cohort: diversity of clinical manifestations and Gb3 levels. J Inherit Metab Dis 30:68–78

    Article  PubMed  CAS  Google Scholar 

  17. Mehta A, Ricci R, Widmer U, Dehout F, Garcia de Lorenzo A, Kampmann C, Linhart A, Sunder-Plassmann G, Ries M, Beck M (2004) Fabry disease defined: baseline clinical manifestations of 366 patients in the Fabry Outcome Survey. Eur J Clin Invest 34:236–242

    Article  PubMed  CAS  Google Scholar 

  18. Schiffmann R (2009) Fabry disease. Pharmacol Ther 122:65–77

    Article  PubMed  CAS  Google Scholar 

  19. Moore Df, Altarescu G, Ling GS, Jeffries N, Frei KP, Weibel T, Charria-Ortiz G, Ferri R, Arai AE, Brady RO, Schiffmann R (2002) Elevated cerebral blood flow velocities in Fabry disease with reversal after enzyme replacement. Stroke 33:525–531

    Article  PubMed  Google Scholar 

  20. Grewal RP (1994) Stroke in Fabry’s disease. J Neurol 241:153–156

    Article  PubMed  CAS  Google Scholar 

  21. Fellgiebel A, Muller MJ, Mazanek M, Baron K, Beck M, Stoeter P (2005) White matter lesion severity in male and female patients with Fabry disease. Neurology 65:600–602

    Article  PubMed  CAS  Google Scholar 

  22. Ries M, Clarke JT, Whybra C, Timmons M, Robinson C, Schlaggar BL, Pastores G, Lien YH, Kampmann C, Brady RO, Beck M, Schiffmann R (2006) Enzyme-replacement therapy with agalsidase alfa in children with Fabry disease. Pediatrics 3:924–932

    Article  Google Scholar 

  23. Schiffmann R, Warnock D, Banikazemi M, Bultas J, Linthorst G, Packman S, Sorensen S, Wilcox W, Desnick R (2009) Fabry disease: progression of nephropathy, and prevalence of cardiac and cerebrovascular events before enzyme replacement therapy. Nephrol Dial Transplant 24:2102–2111

    Article  PubMed  Google Scholar 

  24. Mitsias P, Levine SR (1996) Cerebrovascular complications of Fabry’s disease. Ann Neurol 40:8–17

    Article  PubMed  CAS  Google Scholar 

  25. Kleinert J, Dehout F, Schwarting A, de Lorenzo AG, Ricci R, Kampmann C, Beck M, Ramaswani U, Linhart A, Gal A, Houge G, Widmer U, Mehta A, Sunder-plassman G (2006) Prevalence of uncontrolled hypertension in patients with Fabry disease. Am J Hypertens 19:782–787

    Article  PubMed  Google Scholar 

  26. Jain G, Warnock DG (2011) Blood pressure, proteinuria and nephropathy in Fabry disease. Nephron Clin Pract 118:c43–c48

    Article  PubMed  Google Scholar 

  27. Crutchfield KE, Patronas NJ, Dambrosia JM, Frei KP, Benerjee TK, Barton NW, Schiffmann R et al (1998) Quantitative analysis of cerebral vasculopathy in patients with Fabry disease. Neurology 50:1746–1749

    Article  PubMed  CAS  Google Scholar 

  28. Hilz MJ, Kolodny EH, Brys M, Stemper B, Haendel T, Marthol H (2004) Reduced cerebral blood flow velocity and impaired cerebral autoregulation in patients with fabry disease. J Neurol 251(5):564–570

    Article  PubMed  Google Scholar 

  29. Moore DF, Kaneski CR, Askari H, Schiffmann R (2007) The cerebral vasculopathy of Fabry disease. J Neurol Sci 257:258–263

    Article  PubMed  Google Scholar 

  30. Moore DF, Scott LT, Gladwin MT, Altarescu G, Kaneski C, Suzuki K, Pease-Fye M, Ferri R, Brady RO, Herscovitch P, Schiffmann R (2001) Regional cerebral hyperperfusion and nitric oxide pathway dysregulation in Fabry disease: reversal by enzyme replacement therapy. Circulation 104(13):1506–1512

    Article  PubMed  CAS  Google Scholar 

  31. Gupta S, Ries M, Kotsopoulos S, Schiffmann R (2005) The relationship of vascular glycolipid storage to clinical manifestations of Fabry disease: a cross-sectional study of a large cohort of clinically affected heterozygous women. Medicine 84(5):261–268

    Article  PubMed  CAS  Google Scholar 

  32. DeGraba T, Azhar S, Dignat-George F, Brown E, Boutiere B, Altarescu G, McCarron R, Schiffmann R (2000) Profile of endothelial and leukocyte activation in Fabry patients. Ann Neurol 47(2):229–233

    Article  PubMed  CAS  Google Scholar 

  33. Igarashi T, Sakuraba H, Suzuki Y (1986) Activation of platelet function in Fabry’s disease. Am J Hematol 22(1):63–67

    Article  PubMed  CAS  Google Scholar 

  34. Gambarin IF, Disabella E, Narula J, Diegoli M, Grasso M, Serio A, Favalli V, Agozzino M, Tavazzi L, Fraser AG, Arbustini E (2010) When should cardiologists suspect Anderson-Fabry disease. Am J Cardiol 106:1492–1499

    Article  PubMed  Google Scholar 

  35. Moon JC, Sachdev B, Elkington AG, Mc Kenna WJ, Metha A, Pennell DJ, Leed PJ, Elliot PM (2003) Gadolinium enhanced cardiovascular magnetic resonance in Anderson-Fabry disease. Evidence for a disease specific abnormality of the myocardial interstitium. Eur Heart J 24:2151–2155

    Article  PubMed  Google Scholar 

  36. Eng CM, Germain DP, Banikazemi M, Warnock DG, Wanner C, Hopkin RJ, Bultas J, Lee P, Sims K, Brodie SE, Pastores GM, Strotmann JM, Wilcox WR (2006) Fabry disease: guidelines for the evaluation and management of multiorgan system involvement. Genet Med 8:539–548

    Article  PubMed  Google Scholar 

  37. Politei JM (2009) Can we use statins to prevent stroke in Fabry disease? J Inherit Metab Dis 32:481–487

    Article  PubMed  CAS  Google Scholar 

  38. Demuth K, Germain DP (2002) Endothelial markers and homocysteine in patients with classic Fabry disease. Acta Paediatr Suppl 91:57–61

    Article  PubMed  CAS  Google Scholar 

  39. Zenone T, Chan V ((2011) Young woman with recurrent ischemic strokes diagnosed as Fabry disease: lessons learned from a case report. Clin Neurol Neurosurg. doi:10.1016/j.clineuro.2011.02.012

    PubMed  Google Scholar 

  40. Lidove O, West ML, Pintos-Morell G, Reisin R, Nicholls K, Figuera LE, Parini R, Carvalho LR, Kampmann C, Pastores GM, Mehta A (2010) Effects of enzyme replacement therapy in Fabry disease—a comprehensive review of the medical literature. Genet Med 11:668–679

    Article  Google Scholar 

  41. Schiffmann R, Ries M, Timmons M, Flaherty JT, Brady RO (2006) Long-term therapy with agalsidase alfa for Fabry disease: safety and effects on renal function in a home infusion setting. Nephrol Dial Transplant 21:345–354

    Article  PubMed  CAS  Google Scholar 

  42. Wilcox WR, Banikazemi M, Guffon N, Waldek S, Lee P, Linthorst GE, Desnick RJ, Germain DP, International Fabry Disease Study Group (2004) Long-term safety and efficacy of enzyme replacement therapy for Fabry disease. Am J Hum Genet 75:65–74

    Article  PubMed  CAS  Google Scholar 

  43. Jardim L, Vedolin L, Schwartz VD, Burin MG, Cecchin C, Kalakun L, Matte U, Aesse F, Pitta-Pinheiro C, Marconato J, Giugliani R (2004) CNS involvement in Fabry disease: clinical and imaging studies before and after 12 months of enzyme replacement therapy. J Inherit Metab Dis 27:229–240

    Article  PubMed  CAS  Google Scholar 

  44. Yamadera M, Yokoe M, Beck G, Mihara M, Oe H, Yamamoto Y, Sakoda S (2009) Amelioration of white-matter lesions in a patient with Fabry disease. J Neurol Sci 279:118–120

    Article  PubMed  CAS  Google Scholar 

  45. Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, Halperin JL, Johnston SC, Katzan I, Kernan WN, Mitchell PH, Ovbiagele B, Palesch YY, Sacco RL, Schwamm LH, Wassertheil-Smoller S, Turan TN, Wentworth D (2011) American Heart Association Stroke Council, Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Interdisciplinary Council on Quality of Care and Outcomes Research. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the american heart association/american stroke association. Stroke 42(1):227–276

    Article  PubMed  Google Scholar 

  46. Cabrera-Salazar MA, O’Rourke E, Charria-Ortiz G, Barranger JA (2005) Radiological evidence of early cerebral microvascular disease in young children with Fabry disease. J Pediatr 147:102–105

    Article  PubMed  Google Scholar 

  47. Albrecht J, Dellani PR, Müller MJ, Schermuly I, Beck M, Stoeter P, Gerhard A, Fellgiebel A (2007) Voxel based analyses of diffusion tensor imaging in Fabry disease. J Neurol Neurosurg Psychiatry 78:964–969

    Article  PubMed  CAS  Google Scholar 

  48. Moore DF, Altarescu G, BArker WC, Patronas NJ, Herscovitch P, Schiffmann R (2003) White matter lesions in Fabry disease occur in prior selectively hypometabolic and hyperperfused brain regions. Brain Res Bull 62:231–240

    Article  PubMed  CAS  Google Scholar 

  49. Vedder AC, Linthorst GE, Houge G, Groener JE, Ormel EE, Bouma BJ, Aerts JM, Hirth A, Hollak CE (2007) Treatment of Fabry disease: outcome of a comparative trial with agalsidase alfa or beta at a dose of 0.2 mg/kg. PLoS One 2:e598

    Article  PubMed  Google Scholar 

  50. Schermuly I, Müller MJ, Müller KM, Albrecht J, Keller I, Yakushev I, Beck M, Fellgiebel A (2011) Neuropsychiatric symptoms and brain structural alterations in Fabry disease. Eur J Neurol 18(2):347–353

    Article  PubMed  CAS  Google Scholar 

  51. Politei JM, Capizzano AA (2006) Magnetic resonance image findings in 5 young patients with Fabry disease. Neurologist 12(2):103–105

    Article  PubMed  Google Scholar 

  52. O’Sullivan M, Morris RG, Huckstep B, Jones DK, Williams SC, Markus HS (2004) Diffusion tensor MRI correlates with executive dysfunction in patients with ischaemic leukoaraiosis. J Neurol Neurosurg Psychiatry 75(3):441–447

    Article  PubMed  Google Scholar 

  53. Viana-Baptista M, Bugalho P, Jordão C, Ferreira N, Ferreira A, Forjaz Secca M, Esperança-Pina JA, Ferro JM (2008) Cognitive function correlates with frontal white matter apparent diffusion coefficients in patients with leukoaraiosis. J Neurol 255(3):360–366

    Article  PubMed  Google Scholar 

  54. Germain DP (2010) Fabry disease. Orphanet J Rare Dis 5:30

    Article  PubMed  Google Scholar 

  55. Fellgiebel A, Keller I, Marin D, Müller MJ, Schermuly I, Yakushev I, Albrecht J, Bellhäuser H, Kinateder M, Beck M, Stoeter P (2009) Diagnostic utility of different MRI and MR angiography measures in Fabry disease. Neurology 72(1):63–68

    Article  PubMed  CAS  Google Scholar 

  56. Buechner S, Moretti M, Burlina AP, Cei G, Manara R, Ricci R, Mignani R, Parini R, Di Vito R, Giordano GP, Simonelli P, Siciliano G, Borsini W (2008) Central nervous system involvement in Anderson-Fabry disease: a clinical and MRI retrospective study. J Neurol Neurosurg Psychiatry 79:1249–1254

    Article  PubMed  CAS  Google Scholar 

  57. Tedeschi G, Bonavita S, Banerjee TK, Virta A, Schiffmann R (1999) Diffuse central neuronal involvement in Fabry disease: a proton MRS imaging study. Neurology 52:1663–1667

    Article  PubMed  CAS  Google Scholar 

  58. Marino S, Borsini W, Buchner S, Mortilla M, Stromillo ML, Battaglini M, Giorgio A, Bramanti P, Federico A, De Stefano N (2006) Diffuse structural and metabolic brain changes in Fabry disease. J Neurol 253(4):434–440

    Article  PubMed  CAS  Google Scholar 

  59. Ringelstein EB, Kleffner I, Dittrich R, Kuhlenbäumer G, Ritter MA (2010) Hereditary and non-hereditary microangiopathies in the young. An up-date. J Neurol Sci 299(1–2):81–85

    Article  PubMed  Google Scholar 

  60. Fellgiebel A, Keller I, Martus P, Ropele S, Yakushev I, Böttcher T, Fazekas F, Rolfs A (2011) Basilar artery diameter is a potential screening tool for fabry disease in young stroke patients. Cerebrovasc Dis 31(3):294–299

    Article  PubMed  Google Scholar 

  61. Moore DF, Ye F, Schiffmann R, Butman JA (2003) Increased signal intensity in the pulvinar on T1-weighted images: a pathognomonic MR imaging sign of Fabry disease. Am J Neuroradiol 24:1096–1101

    PubMed  Google Scholar 

  62. Takanashi J, Barkovich AJ, Dillon WP, Sherr EH, Hart KA, Packman S (2003) T1 hyperintensity in the pulvinar: key imaging feature for diagnosis of Fabry disease. Am J Neuroradiol 24:916–921

    PubMed  Google Scholar 

  63. Burlina AP, Manara R, Caillaud C, Laissy JP, Severino M, Klein I, Burlina A, Lidove O (2008) The pulvinar sign: frequency and clinical correlations in Fabry disease. J Neurol 255:738–744

    Article  PubMed  Google Scholar 

  64. Manara R, Ginsberg L, Severino S, Valentine AR, Kendall B, Clarke JTR, Mehta A, Burlina AP (2007) White matter and pulvinar signal abnormalities in Fabry disease: data from the Fabry Outcome Survey (FOS). J Neurol 254(Suppl 3):III/13

    Google Scholar 

  65. Linthorst GE, Bouwman MG, Wijburg FA, Aerts JM, Poorthuis BJ, Hollak CE (2010) Screening for Fabry disease in high-risk populations: a systematic review. J Med Genet 47(4):217–222

    Article  PubMed  CAS  Google Scholar 

  66. Desnick RJ, Brady R, Barranger J, Collins AJ, Germain DP, Goldman M, Grabowski G, Packman S, Wilcox WR (2003) Fabry disease, an underrecognized multisystemic disorder: expert recommendations for diagnosis, management, and enzyme replacement therapy. Ann Intern Med 138:338–346

    PubMed  Google Scholar 

  67. Gregoire SM, Brown MM, Collas DM, Jacob P, Lachmann RH, Werring DJ (2009) Posterior circulation strokes without systemic involvement as the presenting feature of Fabry disease. J Neurol Neurosurg Psychiatry 12:1414–1416

    Article  Google Scholar 

  68. Rolfs A, Martus P, Heuschmann PU, Grittner U, Holzhausen M, Tatlisumak T, Böttcher T, Fazekas F, Enzinger C, Ropele S, Schmidt R, Riess O, Norrving B (2011) Protocol and methodology of the stroke in young Fabry patients (Sifap1) study: a prospective multicenter European study of 5,024 young stroke patients aged 18–55 years. Cerebrovasc Dis 31(3):253–262

    Article  PubMed  Google Scholar 

  69. Brouns R, Thijs V, De Eyskens F, Deyn PP (2011) Response to letter regarding Belgian Fabry study: Prevalence of Fabry disease in a cohort of 1,000 young patients with cerebrovascular disease. Stroke 42:e6–e7

    Article  Google Scholar 

  70. Baumgartner R (2011) Prevalence of Fabry disease in ischemic stroke of unknown etiology. Available at: http://www.researchportal.ch/unizh/p8126.htm. Accessed June 2011

  71. Clavelou P (2011) Fabry: National Initiative of Screening (FIND). Available at: http://clinicaltrials.gov/ct2/show/NCT00484549?term=fabry&rank=10. Accessed June 2011

  72. Baptista MV, PORTYSTROKE investigators. 2011 Response to Letter Regarding Article, “Mutations of the GLA Gene in Young Patients With Stroke: The PORTYSTROKE Study-Screening Genetic Conditions in PORTuguese Young STROKE Patients”. Stroke; 42: e9

  73. Froissart R, Guffon N, Vanier MT, Desnick RJ, Maire I (2003) Fabry disease: D313Y is an alpha-galactosidase A sequence variant that causes pseudodeficient activity in plasma. Mol Genet Metab 80:307–314

    Article  PubMed  CAS  Google Scholar 

  74. Chien YH (2009) Novel human pathological mutations: gene symbol: GLA disease: Fabry disease. Hum Genet 125:336

    Google Scholar 

  75. Wozniak MA, Kittner SJ, Cole JW, Stern B, Tuhrim S, Desnick RJ (2011) Response to letter regarding frequency of unrecognized Fabry disease among young European–American and African–American men with first ischemic stroke. Stroke 42: e8

  76. Lidove O, Joly D, Touze’ E (2011) Letter regarding Brouns et al. Baptista et al. and Wozniak et al. Stroke 42:e4–e5

    Article  PubMed  Google Scholar 

  77. Carolei A, Marini C, Ferranti E, Frontoni M, Prencipe M, Fieschi C (1993) A prospective study of cerebral ischemia in the young. Analysis of pathogenic determinants. Stroke 24:362–367

    Article  PubMed  CAS  Google Scholar 

  78. Kristensen B, Malm J, Carlberg B, Stegmayr B, Backman C, Fagerlund M, Olsson T (1997) Epidemiology and etiology of stroke in young adults aged 18 to 44 years in northern Sweden. Stroke 28:1702–1709

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

M.V.B. has received speaker’s fees from Genzyme Corp. M.V.B. coordinated the PORTYSTROKE study that was sponsored by an unrestricted grant from GENZYME–Portugal. M.V.B. served as an advisor on the Global Fabry Neurology Advisory Board, sponsored by Genzyme Corp.

Author information

Authors and Affiliations

  1. Departamento de Neurologia, CEDOC, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, 1169-056, Lisbon, Portugal

    Miguel Viana-Baptista

  2. Serviço de Neurologia, Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Rua da Junqueira 126, 1349-019, Lisbon, Portugal

    Miguel Viana-Baptista

Authors
  1. Miguel Viana-Baptista
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miguel Viana-Baptista.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Viana-Baptista, M. Stroke and Fabry disease. J Neurol 259, 1019–1028 (2012). https://doi.org/10.1007/s00415-011-6278-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-011-6278-4

Keywords

Search

Navigation