BACKGROUND: Approximately 10% to 14% of ischemic strokes occur in young adults. OBJECTIVE: To investigate the yield of diagnostic tests, neuroimaging findings, and treatment of ischemic strokes in young adults. DESIGN: We retrospectively reviewed data from our Get with the Guidelines-Stroke database from 2005 through 2010. SETTING: University hospital tertiary stroke center. PATIENTS: A total of 215 consecutive inpatients aged 18 to 45 years with ischemic stroke/transient ischemic attack. The mean (SD) age was 37.5 (7) years; 51% were male. RESULTS: There were high incidence rates of hypertension (20%), diabetes mellitus (11%), dyslipidemia (38%), and smoking (34%). Relevant abnormalities were shown on cerebral angiography in 136 of 203 patients, on cardiac ultrasonography in 100 of 195, on Holter monitoring in 2 of 192; and on hypercoagulable panel in 30 of 189 patients. Multiple infarcts were observed in 31% and were more prevalent in individuals younger than age 35 years. Relevant arterial lesions were frequently detected in the middle cerebral artery (23%), internal carotid artery (13%), and vertebrobasilar arteries (13%). Cardioembolic stroke occurred in 47% (including 17% with isolated patent foramen ovale), and 11% had undetermined stroke etiology. The median National Institutes of Health Stroke Scale score was 3 (interquartile range, 0-9) and 81% had good outcome at hospital discharge. Of the 29 patients receiving thrombolysis (median National Institutes of Health Stroke Scale score, 14; interquartile range, 9-17), 55% had good outcome at hospital discharge and none developed symptomatic brain hemorrhage. CONCLUSIONS: This study shows the contemporary profile of ischemic stroke in young adults admitted to a tertiary stroke center. Stroke etiology can be determined in nearly 90% of patients with modern diagnostic tests. The causes are heterogeneous; however, young adults have a high rate of traditional vascular risk factors. Thrombolysis appears safe and short-term outcomes are favorable.
BACKGROUND: Approximately 10% to 14% of ischemic strokes occur in young adults. OBJECTIVE: To investigate the yield of diagnostic tests, neuroimaging findings, and treatment of ischemic strokes in young adults. DESIGN: We retrospectively reviewed data from our Get with the Guidelines-Stroke database from 2005 through 2010. SETTING: University hospital tertiary stroke center. PATIENTS: A total of 215 consecutive inpatients aged 18 to 45 years with ischemic stroke/transient ischemic attack. The mean (SD) age was 37.5 (7) years; 51% were male. RESULTS: There were high incidence rates of hypertension (20%), diabetes mellitus (11%), dyslipidemia (38%), and smoking (34%). Relevant abnormalities were shown on cerebral angiography in 136 of 203 patients, on cardiac ultrasonography in 100 of 195, on Holter monitoring in 2 of 192; and on hypercoagulable panel in 30 of 189 patients. Multiple infarcts were observed in 31% and were more prevalent in individuals younger than age 35 years. Relevant arterial lesions were frequently detected in the middle cerebral artery (23%), internal carotid artery (13%), and vertebrobasilar arteries (13%). Cardioembolic stroke occurred in 47% (including 17% with isolated patent foramen ovale), and 11% had undetermined stroke etiology. The median National Institutes of Health Stroke Scale score was 3 (interquartile range, 0-9) and 81% had good outcome at hospital discharge. Of the 29 patients receiving thrombolysis (median National Institutes of Health Stroke Scale score, 14; interquartile range, 9-17), 55% had good outcome at hospital discharge and none developed symptomatic brain hemorrhage. CONCLUSIONS: This study shows the contemporary profile of ischemic stroke in young adults admitted to a tertiary stroke center. Stroke etiology can be determined in nearly 90% of patients with modern diagnostic tests. The causes are heterogeneous; however, young adults have a high rate of traditional vascular risk factors. Thrombolysis appears safe and short-term outcomes are favorable.
Authors: Aneesh B Singhal; José Biller; Mitchell S Elkind; Heather J Fullerton; Edward C Jauch; Steven J Kittner; Deborah A Levine; Steven R Levine Journal: Neurology Date: 2013-08-14 Impact factor: 9.910
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Authors: Barbara Goeggel Simonetti; Marie-Luise Mono; Uyen Huynh-Do; Patrik Michel; Celine Odier; Roman Sztajzel; Philippe Lyrer; Stefan T Engelter; Leo Bonati; Henrik Gensicke; Christopher Traenka; Barbara Tettenborn; Bruno Weder; Urs Fischer; Aekaterini Galimanis; Simon Jung; Rudolf Luedi; Gian Marco De Marchis; Anja Weck; Carlo W Cereda; Ralf Baumgartner; Claudio L Bassetti; Heinrich P Mattle; Krassen Nedeltchev; Marcel Arnold Journal: J Neurol Date: 2015-06-12 Impact factor: 4.849
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Authors: Noortje A M M Maaijwee; Loes C A Rutten-Jacobs; Pauline Schaapsmeerders; Ewoud J van Dijk; Frank-Erik de Leeuw Journal: Nat Rev Neurol Date: 2014-04-29 Impact factor: 42.937