2026 American Academy of Neurology Abstract Website

Objective:

To evaluate the impact of diabetes mellitus on stroke recurrence in female patients with cryptogenic acute ischemic stroke and benign uterine myomas.

Background:

There is limited data on acute ischemic stroke patients with benign uterine myomas. Initial studies have explored mechanisms such as paradoxical embolism and hypercoagulability. Diabetes mellitus, a significant vascular risk factor, may contribute to stroke recurrence by promoting endothelial dysfunction and inflammation, potentially increasing thrombotic risk. This study investigates diabetes as a modifier of stroke recurrence in patients with uterine myomas.

Design/Methods:

A retrospective review was conducted at a comprehensive stroke center for female patients aged 18-60 years with cryptogenic acute ischemic stroke and confirmed benign uterine myomas from 2017 – 2024. The primary outcome was stroke recurrence, defined as re-admission within one year. Co-morbid factors such as hypertension, atrial fibrillation, anti-coagulant use, and diabetes were assessed. Exclusion criteria included other known hypercoagulable risk factors such as malignancy, clotting disorders, pregnancy, deep vein thrombosis (DVT), or pulmonary embolism (PE). Statistical analysis methods included Wilcoxon Rank Sum and Fisher’s Exact Testing.

Results:

Sixty-four female patients (mean age +/- SD: 46.2 ± 7.2 years) were included. Six patients (9.4%) experienced stroke recurrence. Diabetes mellitus was significantly more prevalent in those with recurrence (50.0% versus 10.9%, p = 0.03). No significant differences were found in age, anticoagulation status, or other co-morbidities. Length of hospital stay was also significantly higher among those with stroke recurrence (3.8 days versus 2.3 days, p = 0.028).

Conclusions:

While overall stroke recurrence rate was low, diabetes mellitus was significantly associated with increased risk of stroke recurrence in patients with uterine myomas. The combined effects of diabetes-induced vascular dysfunction and uterine myoma-associated hypercoagulability may heighten thrombotic risk. However, larger prospective studies are needed for further corroboration.