Related Experiment Videos
[Cerebral ischemia in young adults]
P Berlit1, B Endemann, P Vetter
1Neurologische Klinik im Klinikum Mannheim, Universität Heidelberg.
Insights
Cerebral ischemia in individuals under 40 is often caused by premature atherosclerosis or cardiogenic embolism. Prognosis for young adults with stroke is generally better than for older patients, highlighting the need for early diagnosis and intervention.
Area of Science:
- Neurology
- Vascular Medicine
- Epidemiology
Context:
- Cerebral ischemia (stroke) in young adults (<40 years) presents unique etiological and prognostic considerations compared to older populations.
- A 19-year study analyzed 168 young patients diagnosed with cerebral ischemia.
Purpose:
- To provide a comprehensive overview of the causes (etiology) and outcomes (prognosis) of cerebral ischemia in patients under the age of 40.
- To identify common risk factors and specific conditions leading to stroke in this demographic.
Summary:
- Premature atherosclerosis with vascular risk factors is the leading cause (up to 50%).
- Cardiogenic embolism (e.g., from valve disease, endocarditis) accounts for 1-34%.
- Other causes include vasculitis (2-19%), noninflammatory vasculopathies (dissection, fibromuscular dysplasia, malformations), migrainous stroke, pregnancy-related events (sinus thrombosis, arterial ischemia), hematologic disorders (polycythemia, sickle cell anemia), and ergot derivative ingestion.
Impact:
- Understanding the diverse etiologies of stroke in young adults is crucial for targeted prevention and treatment strategies.
- The generally better prognosis for young stroke patients underscores the importance of early detection and management to improve long-term outcomes.
Abstract:
An overview is given over etiology and prognosis of cerebral ischemias until the age of 40. In a time period of 19 years, 168 patients were diagnosed with cerebral ischemia until the age of 40 (91 females, 77 males). The most frequent etiology is premature atherosclerosis in patients with vascular risk factors (up to 50%). Cardiogenic embolism is responsible for 1 to 34% of the cases: cardiac valve diseases and endocarditis being the most frequent sources. In 2 to 19% a vasculitis is diagnosed. While infectious arteritis is especially frequent in countries of the third world, immunovasculitides are common in Europe and the USA. Noninflammatory vasculopathies include spontaneous or traumatic dissection, fibromuscular dysplasia and vascular malformations. A migrainous stroke is especially frequent in female smokers with intake of oral contraceptives. During pregnancy both sinus thrombosis and arterial ischemia occur. Hematologic causes for ischemia are polycythemia, thrombocytosis and genetic diseases (sickle cell anemia, AT3-deficiency). Cerebral ischemia may occur in connection with the ingestion of ergot-derivates. The prognosis of cerebral ischemia in young adults is better than in older stroke-patients.