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Ischemic stroke in young adults: an overview of etiological aspects

Fábio Iuji Yamamoto1

  • 1Division of Neurology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. fabioyamamoto@hcnet.usp.br

Arquivos De Neuro-Psiquiatria
|June 16, 2012
PubMed

Insights

Atherosclerosis is increasing in young adults, leading to ischemic stroke (IS). Other causes like cardiac embolism and dissection are common in younger populations, but undetermined causes remain significant.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Public Health

Background:

  • Ischemic stroke (IS) predominantly affects individuals over 65, with atherosclerosis as a primary cause.
  • In younger populations (<45 years), cardiac embolism and arterial dissection are more common IS etiologies.
  • There is a concerning rise in atherosclerosis-related IS among younger individuals, potentially due to poor management of vascular risk factors.

Purpose of the Study:

  • To investigate the changing landscape of ischemic stroke causes in different age groups.
  • To highlight the increasing role of atherosclerosis in young stroke patients.
  • To emphasize the need for comprehensive etiological investigation in young stroke cases.

Main Methods:

  • Review of epidemiological data on stroke etiology across age demographics.
  • Analysis of risk factor prevalence in young stroke patients.
  • Comparison of etiological factors between younger and older stroke populations.

Main Results:

  • Atherosclerosis is a growing cause of IS in individuals under 45.
  • Traditional vascular risk factors are increasingly implicated in young-onset IS.
  • Cardiac embolism and arterial dissection remain significant causes in younger demographics.
  • Undetermined causes account for up to one-third of IS cases in young adults.
  • In endemic areas, neurocysticercosis and Chagas' disease are potential contributing factors.

Conclusions:

  • The etiopathogenesis of ischemic stroke is shifting, with a notable increase in atherosclerosis-related events among younger populations.
  • Effective control of traditional vascular risk factors is crucial for preventing IS in all age groups.
  • Further research is needed to elucidate the causes of undetermined strokes in young adults and consider regional endemic diseases.

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