scholarly journals Study of Risk Factors and Clinical Profile of Stroke in Young Adults

2015 ◽  
Vol 2 (1) ◽  
pp. 15
Author(s):  
Yogesh L. Jadhav ◽  
Shailesh A. Bondarde

<strong>Background:</strong> According to the Global Health Observatory, stroke is the second most common cause of death during last decade with a rising trend. Although stroke is considered to be the disease of older population, with the demographic shift the disease incidence is now shifting to younger age group. This shifting trend to younger age group pose a great concern to the world in terms of days lost to work and mortality. There is paucity of information on stroke in young individuals covering important types of stroke. <strong>Aims&amp;Objectives:</strong> To study the clinical profile and risk factors associated with the stroke in young adults. <strong>Materials &amp; Methods:</strong> The present descriptive study was carried out at tertiary care Hospital of Nasik from June 2011 to June 2013. A total of 40 consecutive cases between 15-45 years presenting with stroke were recruited for the study after taking prior informed consent. All cases underwent a detailed history taking, general and clinical examination along with all required Investigations. Data was analysed by SPSS software ver. 17 using appropriate statistical tests. <strong>Results:</strong> Ischemic stroke was the most common presentation and stroke prevalence was similar across both genders. Headache was the most common symptom followed by vomiting in all types of stroke patients. OC Pills and parity was found to significantly associated with CVST. Obesity, smoking and abnormal lipid profile was found to be significantly associated with thromboemblic stroke. Only 3 out of 40 stroke patients died during the course of study. <strong>Conclusion:</strong> OC Pills and parity were significantly associated with CVST while obesity, smoking and dyslipidemia were significantly associated with thromboemblic stroke. Outcome in young stroke patients was fairly good.

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031144
Author(s):  
Merel Ekker ◽  
Mina Jacob ◽  
Myrna van Dongen ◽  
Karoliina Aarnio ◽  
Arunkar Annamalai ◽  
...  

IntroductionWorldwide, 2 million patients aged 18–50 years suffer a stroke each year, and this number is increasing. Knowledge about global distribution of risk factors and aetiologies, and information about prognosis and optimal secondary prevention in young stroke patients are limited. This limits evidence-based treatment and hampers the provision of appropriate information regarding the causes of stroke, risk factors and prognosis of young stroke patients.Methods and analysisThe Global Outcome Assessment Life-long after stroke in young adults (GOAL) initiative aims to perform a global individual patient data meta-analysis with existing data from young stroke cohorts worldwide. All patients aged 18–50 years with ischaemic stroke or intracerebral haemorrhage will be included. Outcomes will be the distribution of stroke aetiology and (vascular) risk factors, functional outcome after stroke, risk of recurrent vascular events and death and finally the use of secondary prevention. Subgroup analyses will be made based on age, gender, aetiology, ethnicity and climate of residence.Ethics and disseminationEthical approval for the GOAL study has already been obtained from the Medical Review Ethics Committee region Arnhem-Nijmegen. Additionally and when necessary, approval will also be obtained from national or local institutional review boards in the participating centres. When needed, a standardised data transfer agreement will be provided for participating centres. We plan dissemination of our results in peer-reviewed international scientific journals and through conference presentations. We expect that the results of this unique study will lead to better understanding of worldwide differences in risk factors, causes and outcome of young stroke patients.


2019 ◽  
Vol 2 (1) ◽  
pp. 32-39
Author(s):  
Madhavi Karri ◽  
Balakrishnan Ramasamy

Background: Ischemic stroke in young adults is becoming a rising concern with the increase in vulnerability to traditional risk factors and changing lifestyles. Aim: An overview of risk factors, classification, and clinical outcome of ischemic stroke in young adults (19 to 45 years) has been presented. Methods: Data fulfilling the study criteria from the stroke registry between June 2014 and June 2017 were collected, and a detailed proforma was taken that included history, clinical examination, and routine investigations. Selective investigations such as prothrombotic workup and 24-hour Holter monitoring were performed. Stroke was subclassified using the Trial of Org 10172 in Acute Stroke Treatment criteria. National Institute of Health Stroke Scale (NIHSS) scores at baseline and the modified Rankin score (mRS) scoring after 3 months of patients’ admission were calculated. Results: Out of 223 identified cases of ischemic stroke in young adults, 186 (83.4%) were taken for analysis, constituting 7.3% of the total stroke population of 3,059. Among the cases taken for analysis, 137 were males and 49 were females. A total of 150 patients were among the age group of 36 to 45 years. Dyslipidemia, smoking, and alcohol consumption were prevalent in the study group. Atherosclerotic strokes were predominant in the study population. NIHSS scores at admission had a significant impact on mRS scores after 3 months. In this study, only 4% reported the recurrence of stroke, whereas mortality was about 0.02%. Conclusions: Workup required for ischemic stroke in young adults has always been a diagnostic challenge for physicians who treat the stroke patients, and this must be optimized in all health care centers. Despite extensive workup, 23.66% participants were found to be cryptogenic in this study. The clinical outcome was good in this study with less mortality observed.


2016 ◽  
Vol 32 (1) ◽  
pp. 16-20
Author(s):  
Nayeem Anwar ◽  
Md Rezaul Karim Khan ◽  
Nawreen Binte Anwar ◽  
Shamsun Nahar ◽  
- Md Shahidullah

Background: Stroke is serious pathology with a immense impact on the functional and vital prognosis. It is the leading cause of death worldwide. The objective of the study was to observe clinical profile of stroke patients and important risk factors. Methods: It was a cross-sectional descriptive study conducted in the department of Neurology, BangabandhuSheikh Mujib Medical Universiy(BSMMU), Shahbag, Dhaka from August 2014 to November2015. All patients above 18 years of age and both sexes attending the above mentioned department meeting all inclusion and exclusion criterias and confirmed CT/MRI scan of Brain were included in this study. Results: A total of 219 patients were studied. Maximum 93(42.5%) patients were in age group of 61-70 years followed by 51(23.3%) and 30(13.7%), in the age group of 51-60 years and 71-80 years respectively. Male 138(63%) were predominant than female 81(63%). 78(35.61%) patients had weakness in both sides of the body, 66(30.1%) had weakness in the left side and 36(16.4%) had weakness in the right side of the body. 190 (87.7) patients had ischemic stroke and 29(12.3%) had hemorrhagic stroke. Among risk factors dyslipidemia was in 185(84.5%) patients, hypertension, smoking habits, diabetes mellitus and ischemic heart disease were present in 165(75.3%), 120(54.8%), 105(47.9%) and 42 (19.2%) patients respectively. H/O recurrent stroke was present in 55(25%) cases. Conclusion: Stroke cases were male predominant where dyslipidaemia was the most common risk factor, most common type of stroke was ischemic, most common presentation was hemiplegia/monoplegia and commonest age of presentation was seventh decade. Bangladesh Journal of Neuroscience 2016; Vol. 32 (1): 16-20


Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013195
Author(s):  
Mina A. Jacob ◽  
Merel S. Ekker ◽  
Youssra Allach ◽  
Mengfei Cai ◽  
Karoliina Aarnio ◽  
...  

Background and Objectives:There is a worldwide increase in the incidence of stroke in young adults, with major regional and ethnic differences. Advancing knowledge of ethnic and regional variation in causes and outcomes will be beneficial in implementation of regional healthcare services. To study the global distribution of risk factors, causes and 3-month mortality of young ischemic stroke patients, by performing a patient data meta-analysis form different cohorts worldwide.Methods:We did a pooled analysis of individual patient data from cohort studies which included consecutive ischemic stroke patients aged 18-50 years. We studied differences in prevalence of risk factors and causes between different ethnic and racial groups, geographic regions and countries with different income levels. We investigated differences in 3-month mortality by mixed-effects multivariable logistic regression.Results:We included 17,663 patients from 32 cohorts in 29 countries. Hypertension and diabetes were most prevalent in Blacks (hypertension, 52.1%; diabetes, 20.7%) and Asians (hypertension 46.1%, diabetes, 20.9%). Large vessel atherosclerosis and small vessel disease were more often cause of stroke in high-income countries (HICs; both p<0.001), whereas ‘’other determined stroke’’ and ‘’undetermined stroke’’ were higher in low and middle-income countries (LMICs; both p<0.001). Patients in LMICs were younger, had less vascular risk factors, and despite this, more often died within 3 months than those from HICs (OR 2.49; 95% CI 1.42-4.36).Discussion:The ethnoracial and regional differences in risk factors and causes of stroke at young age provide an understanding of ethnic and racial, and regional differences in incidence of ischemic stroke. Our results also visualize the dissimilarities in outcome after stroke in young adults that exist between LMICs and HICs, which should serve as call to action to improve healthcare facilities in LMICs.


2012 ◽  
Vol 70 (6) ◽  
pp. 462-466 ◽  
Author(s):  
Fábio Iuji Yamamoto

Stroke affects mainly people aged over 65 years, and atherosclerosis predominates as the main etiopathogenic factor in ischemic stroke (IS). On the other hand, cardiac embolism and arterial dissection are the most frequent causes of IS in patients aged less than 45 years. However, inappropriate control of traditional vascular risk factors in young people may be causing a significant increase of atherosclerosis-related IS in this population. Furthermore, a variety of etiologies, many of them uncommon, must be investigated. In endemic regions, neurocysticercosis and Chagas' disease deserve consideration. Undetermined cause has been still reported in as many as one third of young stroke patients.


2021 ◽  
pp. 54-58
Author(s):  
Namrata Khandelwal ◽  
Biman Kanti Ray ◽  
Deep Das

The results of a systematic analysis of patients aged 15-49 years attending stroke clinic in eastern India were evaluated based on based on clinical and imaging features from January 2012– June 2013. Out of 98 patients of stroke, the mean age of ischaemic and haemorrhagic stroke patients was 34.26 years and 32.81 years respectively. Of the 66 patients of ischaemic stroke, 10.4% had large artery atherosclerosis followed by cardio embolic (14.5%) and lacunar (8.3%). Among 32 haemorrhagic stroke patients, aneurysmal bleed (30%) was the most common aetiology. The stroke of other determined aetiology was 52% and in 14.5% aetiology was undetermined. It is evident that the nature and cause of stroke in young adults is different and unique, and they need different diagnostic work. Attempts must be made to formulate specic guidelines aimed at stroke detection, management, prevention, and rehabilitation in the young adults' population.


BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenjuan Xu ◽  
Xiaoyu Zhang ◽  
Huan Chen ◽  
Zhangning Zhao ◽  
Meijia Zhu

Abstract Background Etiologies of acute ischemic stroke in young adults are heterogeneous. Middle cerebral artery (MCA) stenosis is a common finding in Asians which may be an important cause of stroke in young adults. However, studies of stroke in young Asian populations are rare. Our study was to investigate the prevalence and outcome of young stroke patients with MCA stenosis in Chinese populations. Methods Young patients with MCA territory infarction between January 2013 and September 2018 were retrospectively recruited. Subjects were defined as stenosis group (MCA stenosis ≥50%) and no-stenosis group (MCA stenosis<50% or no stenosis) by their MCA stenosis. For patients in stenosis group, they were categorized as uni-MCA stenosis subgroup and multiple stenosis subgroup. Demographic data, risk factors, imaging feature and complications were compared between groups. Prevalence of MCA stenosis and risk factor score (score ≥ 2 or 3) in different age groups were investigated. Modified Rankin Scale (mRS) was used for evaluating functional outcome at discharge (unfavorable outcome: 3–6). Binary logistic regression was performed to determine independent risk factors of unfavorable outcome. Results Two hundred forty-nine young stroke patients were included in our study and 110 (44.2%) patients were defined as stenosis group. 55 (50%) patients were categorized as uni-MCA stenosis subgroup and 55 (50%) were multiple stenosis subgroup. The most common traditional vascular risk factors included hypertension, hyperlipemia, smoking, hyperhomocysteinemia and alcohol consumption. Prevalence of risk factor score ≥ 2 or 3 increased with age, but not incidence of MCA stenosis. By TOAST classification, the most common etiologies were large-artery atherosclerosis (41.0%) and small vessel disease (33.7%). Compared with no-stenosis group, patients in stenosis group were more likely to have large territorial infarct, develop complications and have unfavorable outcome. No significant difference was found between patients in uni-MCA stenosis and multiple stenosis subgroups except history of stroke/TIA, risk factor score ≥ 3 and silent infarct. By logistic regression, hypertension (OR = 3.561; 95%CI, 1.494 to 8.492; p = 0.004), NIHSS scores at admission (OR = 1.438; 95%CI, 1.276 to 1.620; p = 0,000) and infarct size (p = 0.015) independently predicted unfavorable outcome. Conclusions Forty-four point two percent young Chinese adults with MCA territory infarction had MCA stenosis. Prevalence of MCA stenosis did not increase with age. Patients with MCA stenosis had worse clinical outcome, however, only hypertension, NIHSS scores at admission and infarct size were independent predictors.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Elizabeth M Aradine ◽  
Yan Hou ◽  
Kathleen A Ryan ◽  
Prachi Mehndiratta ◽  
Michael S Phipps ◽  
...  

Introduction: Few studies have compared the proportion of ischemic strokes attributable to traditional vascular risk factors (population-attributable risk percent or PAR%) between genders and races. The PAR% is a function of the population prevalence and strength of association of a risk factor. Methods: A population-based case-control study of ischemic stroke in young adults ages 18-49 in the Baltimore-Washington region was used to study the prevalence, odds ratios, and PAR% of hypertension, diabetes, and smoking among blacks and whites. Logistic regression was used to calculate age-adjusted odds ratios. All analyses were stratified by gender. Results: There were 1044 cases and 1099 controls. Of the cases, 47% were black, 54% were women. Roughly a quarter to a third of all strokes in women were attributable to smoking. Due to the higher prevalence of hypertension and a higher odds ratio for hypertension in black men (OR 3.9, 95% CI 2.6-5.9) compared to white men (OR 1.8, 95% CI 1.3-2.6), there was a much higher PAR% for hypertension among black men than white men. See Table 1 for prevalence and Table 2 for PAR% stratified by gender and race. Conclusion: Traditional vascular risk factors have the potential to explain a high proportion of ischemic stroke in young adults. The high proportion of strokes in women attributable to smoking underscores the need for targeted smoking cessation interventions in this population. Diabetes and, especially, hypertension are important contributors to the excess population burden of ischemic stroke among blacks. These findings support the value of early screening and treatment for hypertension in young blacks.


Author(s):  
Ji Y. Chong ◽  
Michael P. Lerario

Traditional vascular risk factors such as hypertension, diabetes, and high cholesterol can contribute to stroke in young adults. In the absence of typical risk factors in a young patient, a more extensive evaluation is needed. Other, more unusual causes of stroke can include autoimmune, infectious, hematological, and toxic etiologies. Often, despite an exhaustive workup, the mechanism of stroke remains cryptogenic in younger patients.


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