Acidente vascular cerebral em pacientes jovens: análise de 164 casos

Zétola, Viviane H. Flumignan; Nóvak, Edison Matos; Camargo, Carlos Henrique Ferreira; Júnior, Hipólito Carraro; Coral, Patrícia; Muzzio, Juliano André; Iwamoto, Fábio M.; Coleta, Marcos Vinícius Della; Werneck, Lineü Cesar

doi:10.1590/s0004-282x2001000500017

Cited by 50 publications

(48 citation statements)

References 25 publications

(39 reference statements)

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“…However, our experience in São Paulo corroborates the findings of Zétola et al in Curitiba, Brazil, who found higher percentages of atherothrombotic stroke in young adults associated with high prevalence of arterial hypertension, smoking, hypercholesterolemia, diabetes mellitus and alcohol abuse 35,36 . Thus, for reducing the burden of stroke also in young populations, it seems very cost-effective prioritizing interventions targeting control of modifiable risk factors, especially in developing countries and minorities in high income nations 37 .…”

Section: Large-artery Atherosclerosissupporting

confidence: 91%

Ischemic stroke in young adults: an overview of etiological aspects

Yamamoto

2012

Arq. Neuro-Psiquiatr.

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Ischemic stroke (IS) in young adults is reported as uncommon, comprising less than 10% of all stroke patients 1 . However, In our clinical practice, we are faced not infrequently with patients aged less than 45 years who suffered a stroke, many of them with no risk factors for atherosclerosis and no ultimate clear etiological diagnosis even after a thorough investigation. This diagnostic challenge is one of the main scopes of studying and researching mechanisms of brain ischemia in young adults in addition to the dramatic personal, familial, and socio-economic consequences by affecting individuals at the top of their productive age.Although cardioembolism and cervicocephalic arterial dissection have been established as principal etiological factors of IS in young adults 2 , a systematic diagnostic approach must be applied to all patients, regarding the great number of potential causes in this group and the multifactorial nature in many of these patients.Despite more accurate diagnostic tools recently acquired in vascular imaging, hematological and genetic studies, currently, the number of young patients with cryptogenic IS remains high, performing 30-40% 3,4 . Considered an unusual cause of IS in the young two decades ago 5 , atherosclerosis has gaining projection by recent reports of significant raise in traditional risk factors as hypertension, diabetes, obesity, dyslipidemia and tabagism among hospitalized adolescents and young adults 6. Table 1 shows the main categorizations of etiologic subtypes of IS in young adults that must be considered in every young patient with IS. NoNAthERoSclERotIc ANgIopAthIES AbStRActStroke 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.Key words: stroke, brain ischemia, young adult. RESumoA doença aterosclerótica é o fator etiopatogênico mais importante no acidente vascular cerebral isquêmico (AVCI), afecção que acomete predominantemente pessoas acima da sétima década de vida. Entretanto, nos adultos jovens a aterosclerose exibe frequência menor, sendo a embolia de origem cardíaca e as dissecções arteriais as causas mais comuns de AVCI em pacientes com até 45 anos de idade. Porém, o controle inadequado dos fatores de risco vascular nas faixas mais jovens da população pode estar levando à elevação significativa no nú-mero de infartos cerebrais associados à aterosclerose nessa faixa etária.Uma ampla gama de fatores etiológicos, muitos deles rar...

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Section: Large-artery Atherosclerosissupporting

confidence: 91%

Ischemic stroke in young adults: an overview of etiological aspects

Yamamoto

2012

Arq. Neuro-Psiquiatr.

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“…In this study the majority of patients at the time of admission showed a moderate stroke severity according to the NIHSS, which is in consonance with Rena et al 9 2014, a study conducted on a stroke unit in Italy, which evaluated 150 patients young adults. When compared the types of stroke, the greater frequency of ischemic stroke in this study corroborates to what has been described in the literature 3,4,18,19,22 , in particular, the proportion of patients diagnosed with hemorrhagic stroke were mostly of hypertensive etiology, reasoning with the findings of previous studies 3,4 . There was a statistically significant difference when comparing female and male with hypertensive etiology of hemorrhagic stroke: the most hypertensive were men, presenting higher frequency of hemorrhagic stroke.…”

supporting

confidence: 92%

“…The higher frequency of females observed in this study, confirms the research conducted on national territory 3,6,10 , including a study in the city of Salvador…”

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confidence: 91%

Clinical and Functional Characteristics of Young Adult Patients Admitted in a Stroke Unit

Makhoul

Maso²,

Monteiro

et al. 2016

BJMHH

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A B S T R A C T BACKGROUND:Previously referred to as rare among young adults, in the last five years was found a frequency approaching 30 % of young adults between those who have suffered a stroke in Brazil. OBJECTIVE: To identify the sociodemographic, clinical and functional characteristics of young adult patients. METHODS: It was a cross-sectional study, conducted with individuals assisted in a stroke unit with ischemic or hemorrhagic stroke diagnosis and age of 18-50 years old between August 2014 to April 2015. It was used the National Institutes of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS). RESULTS: The study population consisted of 47 individuals, in which 28 (59,6%) were female, with an average age of 39,2 (DP±8,3) years, and brown skin color 21 (44,7%). They presented 8,9 years of formal education. 28 (59,6%) patients were diagnosed with ischemic stroke, 30 (63,8%) had involvement of the anterior circulation, and 23 (48,9%) of the left hemisphere. 26 (55,3%) patients presented hypertension and 36 (76,6%) were sedentary. The stroke severity had a median of 7 ( 0-23 ) points and 30 (63,7%) of patients the functional was capacity 5 in the Rakin Scale. It was found a statistically significant difference for hypertensive etiology of hemorrhagic stroke in men ( p = 0,047) when compared with gender and the occurrence of stroke in the right hemisphere in women (p=0,032). CONCLUSION: The profile of the young adult patients from a stroke unit consists of female, of brown skin color, economically active with moderate stroke severity and severe functional disability. According to the World Health Organization, the stroke is the second leading cause of death in the world, after ischemic heart disease¹. In Brazil and other Latin America countries it is the leading cause of death². The age group most commonly affected by stroke is between 70-80 years old due to the aging of nervous and cardiovascular system³ associated with risk factors such as diabetes, hypertension, smoking, physical inactivity, dyslipidemia, heart diseases², among others. Previously referenced as a rare condition among the young adults, with an incidence of 5 to 10% 4.5 , in Brazil, In the last five years have identified a frequency which is close to 40% of young adults between those who had stroke 6 . In addition to the high mortality rate, it is considered as the most disabling of long-term diseases, impacting not only the patient but also their families 7, and the social security and public system 8 . The growing number of young adults affected by stroke has increased the cost of disability benefits, greatly burdening the public health budget and being responsible for 40% of early retirements 8 . Furthermore, the great etiology diversity for stroke in the younger population, diverging from the elderly population in relation to the most important risk factors, topography and most affected vascular territories 9 justifies the need to extend studies on this population. The studies carried out in stroke units are not specific...

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“…Na atualidade não existe um consenso na literatura quanto à idade limite para considerar AVC no adulto jovem, estudos variam entre 45 e 60 anos (Cardoso, Fonseca, & Costa, 2003;Gomes et al, 2008;Zétola et al, 2001). A média de idade dos participantes deste estudo foi de 37,6 anos, cabe ressaltar que a faixa etária estabelecida para este pesquisa foi entre 18 e 45 anos.…”

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Social Support and Occupational Aspects of Adults After Stroke

Trad

Pereira

Baptista

2017

Psic., Saúde & Doenças

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RESUMO:O objetivo do presente estudo foi analisar a relação entre percepção de suporte social e aspectos ocupacionais de adultos jovens após acidente vascular cerebral (AVC). Realizou-se um estudo descritivo transversal, em que também foram analisadas as relações entre a variável percepção de suporte social, Escala de Percepção do Suporte Social (Versão Adulto) -EPSUS-A e outras variáveis demográficas. Participaram da amostra 20 adultos jovens entre 18 e 45 anos com diagnóstico de AVC, 65% do sexo feminino, idade média 37,6 anos e escolaridade média de 9,35 anos de estudo. Os participantes deste estudo perceberam o suporte social positivo após o AVC. Observou-se a existência de associação significativa entre o retorno ao trabalho e a percepção de suporte social. Tais resultados podem indicar que a avaliação da percepção do suporte social baixo poderá identificar indivíduos com maiores dificuldades para o retorno ocupacional. Sendo a maioria dos participantes composto por mulheres em idade produtiva faz-se necessário pensar em programas de prevenção ao AVC para esta população. Palavras-chave: suporte social, ocupação, AVC. ___________________________________________________________________________ SOCIAL SUPPORT AND OCCUPATIONAL ASPECTS OF ADULTS AFTER STROKE ABSTRACT:The present study aimed to analyze the relationship between social support perception and occupational aspects of young adults after stroke. A cross-sectional design was adopted. A social support scale (EPSUS-A) and a demographic questionnaire were used to assess variables. A total of 20 adults, aged 18 to 45 years with a diagnosis of stroke participated, 65% were women, the mean age was 37,6 years, and education mean was 9,35 years. Results showed that the sample perceived positive social support after stroke. There was a significant relation between return to work and perceived social support. Results suggested that assessment of perception of low social support could be a useful tool to identify people with difficulties to return to work. As it seems that the majority of this group consists of women within the productive age range, it is suggested that AVC preventive actions should be addressed to this group as well.

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Acidente vascular cerebral em pacientes jovens: análise de 164 casos

Cited by 50 publications

References 25 publications

Ischemic stroke in young adults: an overview of etiological aspects

Ischemic stroke in young adults: an overview of etiological aspects

Clinical and Functional Characteristics of Young Adult Patients Admitted in a Stroke Unit

Social Support and Occupational Aspects of Adults After Stroke

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