[Diagnosis of stroke in young adults]

42 patients aged up to 35 years who had suffered a stroke were analysed according to etio-pathogenetic and prognostic criteria. The cause of the stroke could be explained with certainty only in ten patients and with high probability in a further eight. In a quarter of the cases the aetiology was completely obscure. Diagnostic gaps exist especially in haemostatic, virological and cardiological areas. Three patients died from the stroke. Follow-up showed that 40% of patients were able to resume their previous occupation. Relapses were observed in cases with disseminated lupus erythematosus and endocarditis. The relatively low rate of clarified cases (42%) is partly due to selection but also to the gaps in diagnostic knowledge. Accordingly, a stepwise diagnostic program was set up, based upon urgency and technical expenditure, that took into account not only the minimal needs for a sound initial diagnosis but also the extensive differential diagnoses for less common causes of stroke.