Stroke in young adults

Tóm tắt

Objective: Stroke is an important cause of morbidity and mortality in young adults especially in developing countries. This study aimed at reviewing epidemiology, types, etiologies, risk factors in the young adults in 108 Military Central Hospital. Subject and method: This study retrospectively reviewed consecutive acute stroke patients aged 16-45 years admitted to the 108 Military Central Hospital between February 1, 2022, and September 18, 2023 to analyze epidemiology, types, etiologies, risk factors, compare the age groups of 16-30 and 31-45 years. Result: Among 319 young stroke patients (mean age at onset 36.4 ± 8.1 years; male 71.5%), there were nontraumatic spontaneous hemorrhagic stroke (including 156 intracerebral hemorrhage (ICH) and 47 subarachnoid hemorrhage, (SAH)), 106 ischemic stroke and 10 cerebral venous thromboses. Notably, ICH was more prevalent in patients aged 16-30 than in those aged 31-45 (63.2% vs 45.8%). Specifically, structural vasculopathy (e.g., arteriovenous malformation, cavernoma) was the most common etiologic subtype in patients aged 16-30 (80.6%), whereas hypertensive ICH was the most common subtype in patients aged 31-45 (57.1%). On the other hand, the top ischemic subtype for both age groups was other determined diseases (e.g., arterial dissection, autoimmune diseases, moyamoya disease, etc.) rather than large artery atherosclerosis. Hyperlipidemia, heart disease and cigarette smoking, excessive alcohol intake were more common risk factors for infarction than ICH. Conclusion: An aggressive approach to elucidate the etiology of stroke must be indicated for all young stroke patients. Structural vasculopathy was the most common etiology in patients aged 16-30, whereas hypertensive ICH was the most common  in patients aged 31-45. For ischemic stroke, in addition to common causes such as cardiac embolism, atherosclerotic cerebrovascular disease... Other causes including arterial dissections, autoimmune diseases, moyamoya disease, cancer-related thromboembolisms, cerebral thrombosis venous complications, hematologic disease...