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Ischaemic cerebral infarction in young adults
F Federico1, T Calvario, N Di Turi
1Università Degli Studi di Bari i Clinica Neurologica.
Insights
This study investigated Ischemic Cerebral Infarction (ICI) in young adults, finding diverse causes and a high acute death rate. While most patients had minor motor deficits, less than half returned to work.
Area of Science:
- Neurology
- Vascular Medicine
- Epidemiology
Background:
- Ischemic Cerebral Infarction (ICI) in young adults (17-45 years) presents a unique clinical challenge.
- Understanding the diverse etiologies and outcomes in this demographic is crucial for effective management.
Purpose of the Study:
- To investigate the etiologies of Ischemic Cerebral Infarction in young patients.
- To analyze the mortality, recurrence, and functional outcomes in this cohort.
Main Methods:
- Retrospective study of 56 patients aged 17-45 years diagnosed with Ischemic Cerebral Infarction.
- Etiological classification included juvenile atherosclerosis, cerebral embolism, coagulopathies, vasculopathies, trauma, migraine, and oral contraceptive use.
- Follow-up assessment of mortality, stroke recurrence, and residual motor deficits.
Main Results:
- Juvenile atherosclerosis was the most common etiology (21 patients), followed by cerebral embolism (13 patients).
- Etiology remained unknown in 6 cases.
- Acute death occurred in 14% of patients, with low rates of recurrent stroke (5%) and non-acute death (3%).
- 80% experienced minimal residual motor deficits, but only 43% returned to their previous work.
Conclusions:
- Young patients with Ischemic Cerebral Infarction represent a heterogeneous group with identifiable causes.
- Despite a high acute mortality, long-term outcomes show significant disability impacting return to work.
Abstract:
Fifty six patients aged 17 to 45 years who had Ischemic Cerebral Infarction (I.C.I.) were studied. The following etiologies were established: 1. Juvenile atherosclerosis (21 patients); 2. Cerebral embolism either from cardiac (10 patients) and from unknown source (3 patients); 3. Secondary coagulopathies (4 patients); 4. Non atherosclerotic vasculopathies (6 patients); 5. Traumas of skull and neck (3 patients); 6. Migraine (2 patients); 7. Oral contraceptives use (1 patient). In 6 cases the etiology remained unknown. Young subjects with I.C.I. are a heterogeneous group: however in most of them a reasonable cause can be found. The occurrence of acute death (14%) was high, while recurrent stroke (5%) and non acute death (3%) were rare when compared to older patients. At the follow-up 80% had a very little residual motor deficit but only 43% were able to return to previous work.