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Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
Ischemic stroke in young patients in Medellín, Colombia
Juan Diego Vargas-Murcia1, Sandra Patricia Isaza-Jaramillo2, Dionis Magnary Vallejo-Mesa2
1Neurology Section, University of Antioquia, Carrera 51D #62-29, Medellín, 050010, Colombia. juan.vargasm@udea.edu.co.
Insights
This study on young ischemic stroke patients in Colombia found traditional risk factors like hypertension and smoking are common. Illicit substance abuse is a notable cause, emphasizing the need for better prevention strategies.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Limited data exists on ischemic stroke in young adults in Colombia.
- This study addresses the knowledge gap by examining stroke causes and risk factors in this demographic.
- Focuses on a tertiary care hospital in Medellin, Colombia.
Purpose of the Study:
- To describe the etiologies and risk factors of ischemic stroke in patients aged 18-49 years in Medellin, Colombia.
- To provide insights into the specific causes and contributing factors for stroke in a young Colombian population.
- To inform prevention and treatment strategies for young stroke patients.
Main Methods:
- Retrospective observational cross-sectional study.
- Reviewed medical records of 237 patients aged 18-49 with first-time ischemic stroke (Jan 2009-Dec 2019).
- Analyzed sociodemographic data, risk factors, and etiological classification using the Trial of Org 10,172 in Acute Stroke Treatment (TOAST) criteria.
Main Results:
- Most frequent risk factors: hypertension (31.7%), smoking (29.5%), alcohol intake (23.2%).
- Etiological classification: undetermined (42.2%), other determined (25.7%), cardioembolism (17.7%).
- Key causes within 'other determined': craniocervical arterial dissection (11.4%) and substance abuse (2.9%).
Conclusions:
- High prevalence of traditional risk factors necessitates optimized primary and secondary prevention.
- Illicit substance abuse is a significant cause of stroke in young Colombians, differing from previous findings.
- Further investigation into undetermined stroke causes and infectious etiologies is warranted.
Background:
There is scarce information about ischemic stroke in young patients in Colombia. To get insights about this phenomenon, this study describes the etiologies and risk factors of ischemic stroke in young patients in a third level complexity referral hospital in Medellin, Colombia.
Methods:
A retrospective observational cross-sectional study was carried out reviewing the medical records of patients between 18 to 49 years old admitted for the first time for ischemic stroke, from January 2009 to December 2019. The sociodemographic characteristics, risk factors, and etiological classification of ischemic stroke according to the Trial of Org 10,172 in Acute Stroke Treatment (TOAST) were described.
Results:
Two hundred thirty-seven cases were found. The most frequent risk factors were arterial hypertension (31.7%), smoking (29.5%) and alcohol intake (23.2%). There was a greater number of traditional cardiovascular risk factors at older ages. The TOAST classification was large-artery atherosclerosis (6.8%), cardioembolism (17.7%), small-vessel disease (7.6%), other determined etiology (25.7%) and undetermined (42.2%). Within cardioembolism, the most common high-risk source was valve replacement, and the most common moderate-risk source was patent foramen ovale. Craniocervical arterial dissection (11.4%) and substance abuse (2.9%) were the two most frequent sources within other determined etiologies. The most common compromised vascular territory was the anterior (55.7%).
Conclusions:
The high frequency of traditional risk factors in young patients highlights the need to optimize primary and secondary prevention plans. This study provides new insights about the relevance of illicit substance abuse in Colombia as a cause of stroke in young patients, unlike the previous one conducted in Bogotá. Infectious causes were other peculiarities found. It is necessary to investigate the reasons for the high proportion of undetermined causes.
