HIV. We therefore investigated HIV infection and other risk factorsfor stroke in Malawi.Methods: We performed a prospective case–controlled study of 222patients (61 were ≤45-years-old) meeting the WHO case definitionof acute stroke, confirmed by MRI and 503 community-based(otherwise healthy) controls, loosely frequency matched for age,sex and place of residence. Multivariate logistic regression modelswere used for case–control comparisons.Results: HIV infection was the predominant risk factor for stroke inunder 45-year-old: recent combined antiretroviral treatment (cART)initiation (adjusted OR 15.36 [3.72,63.41] p b 0.001; populationattributable fraction [PAF] 15%), or untreated HIV infection (3.79[1.54,9.35] p = 0.004; PAF 19%), were the strongest risk factors.Abdominal obesity (PAF 11%) and heating the house with wood (PAF8%) were also important with this younger group. Hypertension didnot have a significant effect (1.36 [0.59,3.10] p = 0.470; PAF 6%).Risk factors for stroke in patients aged ≥45 years were hypertension(8.72 [4.31,17.65] p b 0.001; PAF 68%), smoking (2.67 [1.46,4.87]p = 0.001; PAF 8%)and to a lesser extent, untreated HIV infection(2.58 [1.00,6.66] p = 0.049; PAF 3%) and recent cART initiation (9.55[1.45,62.9] p = 0.019; PAF 2%).Conclusion: A better mechanistic understanding of stroke in thisyoung HIV-infected population and why there is such a strongassociation with cART initiation will be an important step towardsthe reduction of stroke burden in high HIV prevalent settings.

doi:10.1016/j.jns.2013.07.1047

Abstract — WCN 2013No: 3111Topic: 3 — StrokeStrokes of Takayasu disease

D. Hakema, M. Matib, N. Slimania, A. Habouchic, L. Stofc, F. Kessacic,A. Berraha, B. Mansouric. aInternal Medicine, Dr Mohamed-LamineDebaghine, Bab-El-Oued University Hospital Centre, Algiers, Algeria;bNeurology, Hadjout Hospital, Tipaza, Algeria; cRadiology,Dr Mohamed-Lamine Debaghine, Bab-El-Oued University Hospital Centre,Algiers, Algeria

Introduction: Takayasu arteritis (TA) is a chronic inflammatorydisease of the aorta and its main branches and about 10 to 20% ofpatients with TA develop ischaemic stroke (or transient ischaemicattacks).Objectives: To report 2 cases of strokes observed in TA revealing thedisease (1) and occurring at 20 years after the first vascularmanifestations.Observations: Two women aged 40 years old are admitted for stroke'sinvestigations. The first one has an antecedent of vascular surgery in theyounger (humeral stenosis). Both presented strokes with sequellae (1).None have hypertension, valvulopathy, arrythmia, endocarditis or intra-cardiac thrombosis. One patient suffered from ischaemic attacks (in theterritory of a high-grade stenosis of the middle cerebral artery) and thesecond has oneMRI of the brain showed small lesions of thewhitematterthat were presumably of vascular origin. Both have loss pulses. Theinvestigations by sonography and MR angiography there were stillprominent vascular changes of the subclavian and common carotidarteries (2) and several vessels showed a characteristic concentricthickening of the wall on duplex sonography. The renal and the coronaryinvestigations are normal. Upon immunosuppression, the disease took astable course and the evolution was favorable (1) but we have observedneurological sequellae referring to the delay on diagnosis and anappropriate treatment.Conclusion: Strokes are rare but recognized manifestations of TA sothe examination of intracranial vessels (occurrence of intracranial

arterial stenosis) in TA may be helpful for primary or secondaryprevention strategies.

doi:10.1016/j.jns.2013.07.1048

Abstract — WCN 2013No: 2325Topic: 3 — StrokeUnilateral asterixis following thalamic stroke

S. Diasa, J. Sequeiraa, J. Morgadoa, J. Jacintob, A. Caladoa, J. Penaa.aNeurology Department, Centro Hospitalar Lisboa Central, Lisbon,Portugal; bNeuroradiology Department, Centro Hospitalar LisboaCentral, Lisbon, Portugal

Background: Movement disorders are a recognized, albeit rare,complication of ischemic and hemorrhagic stroke. Several types ofhyperkinetic and hypokinetic disorders have been reported, in theacute stage or in a delayed fashion, after vascular lesions in multiplelocations. Thalamic stroke is characterized by prototypical manifes-tations related to the topographical location of the lesions that oftenpoint to the occluded vessels.Objectives:Wedescribe a case of unilateral asterixis following thalamicstroke, highlighting an unusual sign of structural CNS disorders.Patients and methods: Case report.Results: A 75-year old obese woman with a history of hypertension,hyperlipidemia and mild heart failure presented with acute left-sided weakness. Observation revealed left-sided ataxia and hyp-esthesia, with ipsilateral asterixis of the upper limb and bilaterallimitation of ocular abduction. ECG revealed atrial fibrillation, andbrain MRI showed acute lesions in the right postero-lateral thalamus,internal temporal and occipital regions, attributed to embolic strokein the territory of the right PCA and postero-lateral choroidal arteries.Blood work revealed hypercholesterolemia and carotid ultrasoundshowed diffuse intimal thickening and bilateral plaques. Transthoracicechocardiogram showed no evidence of thrombi.Conclusions: Asterixis is characterized by involuntary loss of toneduring posture maintenance, and can be regarded as a form ofnegative myoclonus. It is typically bilateral and associated to toxic ormetabolic encephalopathies. Unilateral presentation is rare and oftenindicative of a focal lesion, especially of the thalamus. Although it is anuncommon sign of stroke, vascular etiology is an important consider-ation, particularly in patients with risk factors.

doi:10.1016/j.jns.2013.07.1049

Abstract — WCN 2013No: 2567Topic: 3 — StrokeClinical features and outcome of stroke in the very elderly

S. El Tawil, Y. Duodu. Milton Keynes General Hospital, Milton Keynes, UK

Background: As the population ages, it is expected that a largerproportion of the stroke population would be aged 85 and more.Specific information about this age group is limited.Objective: To evaluate clinical characteristics, management andoutcome in patients over the age of 85 as compared to patients belowthe age of 85.Patients and methods/material and methods: The study includedall patients discharged from Milton Keynes hospital with a diagnosisof stroke over a period of one year commencing on March 2011. Allpatients above the age of 85 were included in the study. Clinical datawas collected and compared to a similar number of patients belowthe age of 85 admitted during the same period.

Abstracts / Journal of the Neurological Sciences 333 (2013) e215–e278 e275