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Family history of stroke and severity of neurologic deficit after stroke

From the Department of Neurology (J.F.M., T.G.B.), Mayo Clinic, and Department of Neurology (S.S.), University of Florida, Jacksonville, FL; Department of Neurology (R.D.B.), Mayo Clinic, Rochester, MN; Departments of Neurology (B.B.W.) and Public Health Sciences (B.B.W.), University of Virginia, Charlottesville; Department of Biostatistics (L.D.C., S.S.R.), Wake Forest University School of Medicine, Winston–Salem, NC; and Department of Neurology (M.F.), Emory University, Atlanta, GA.

Address correspondence and reprint requests to Dr Meschia, Department of Neurology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224; e-mail: meschia.james{at}mayo.edu

Background: A family history of stroke is an independent risk factor for stroke.

Objective: To assess whether severity of neurologic deficit after stroke is associated with a family history of stroke.

Methods: The Ischemic Stroke Genetics Study, a five-center study of first-ever symptomatic ischemic stroke, assessed case subjects prospectively for a family history of stroke-affected first-degree relatives. Certified adjudicators used the NIH Stroke Scale (NIHSS) to determine the severity of neurologic deficit.

Results: A total of 505 case subjects were enrolled (median age, 65 years; 55% male), with 81% enrolled within 1 week of onset of symptoms. A sibling history of stroke was associated with more severe stroke. The odds of an NIHSS score of 5 or higher were 2.0 times greater for cases with a sibling history of stroke compared with cases with no sibling history (95% CI, 1.0 to 3.9). An association of family history of stroke in parents or children with stroke severity was not detected.

Conclusions: A sibling history of stroke increased the likelihood of a more severe stroke in the case subjects, independent of age, sex, and other potential confounding factors. Other family history characteristics were not associated with stroke severity.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the October 24 issue to find the title link for this article.

*See the appendix on the Neurology Web site (www.neurology.org) for a complete list of the Ischemic Stroke Genetics Study Group.

The Ischemic Stroke Genetics Study is supported by a grant from the National Institute of Neurological Disorders and Stroke (grant no. R01 NS 42733; J.F. Meschia, principal investigator).

Disclosure: The authors report no conflicts of interest.

Received January 26, 2006. Accepted in final form June 20, 2006.

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