Stroke in young adults

Abstract

Background Stroke is the second leading cause of mortality and disability in the world. It is les prevalent in people under 50 years of age but has an important impact on society and the healthcare system. The Trial of Org in Acute Stroke Treatment (TOAST) etiological classification system includes 5 categories: atherothrombotic, cardioembolic, lacunar, rarely occurring (unusual), and of undetermined origin. The etiological range of ischemic stroke in patients under 50 years of age is more heterogeneous than in older patients. Objective To establish the most frequent etiology of ischemic stroke in patients under 50 years of age in Mediláser S.A. clinics of Tunja and Neiva in the years 2013 to 2017. Methodology A descriptive, observational, retrospective, cross-sectional, retrospective study. The clinical history of patients under 50 years of age with a diagnosis of ischemic stroke confirmed by neuroimaging (Computed Tomography – CT or Magnetic Resonance Imaging - MRI) in the aforementioned clinics between 2013 and 2017 was reviewed. The etiology of ischemic stroke was determined according to the TOAST classification. Results 69 patients were identified. The mean age was 39 years (SD: 2). Male/female ratio of 1.3/0.7. Regarding etiology, 22% were associated with cardioembolic origin, 7% atherothrombotic, 4% small vessel, 6% unusual, and 30 % undetermined. The mortality rate was 13% overall. In 70 % of the cases, the cerebral area most affected was the middle cerebral artery. Arterial hypertension was the risk factor most frequently associated with stroke, present in 38% of cases. Conclusions The incidence of ischemic stroke increases significantly after the age of 40 years. Arterial hypertension also represents an important risk factor for experiencing a stroke before the age of 50 years.