Current understanding of stroke and stroke mimics in adolescents and young adults: a narrative review

Stroke in adolescents and young adults are uncommon, and unlike in older adults, the etiology can be a challenging puzzle to solve. Patients often lack traditional risk factors such as hypertension or may be too young for suspected atherosclerotic disease. Additionally, among this group, various stroke mimics exist that can cloud physician judgment, leading to under- or overtreatment.

There is a significant gap in the current literature and clinical evidence regarding stroke in this population. This review of the literature aims to extract important information surrounding the etiology, risk factors, diagnosis, management, and complications of stroke in younger people and address stroke mimics and how they can appear similar and different from ischemic or hemorrhagic stroke. Additionally, we discuss the importance of furthering research in this specific population in all areas due to a concerning rise in stroke frequency and unique associated disabilities.

The acute treatment of stroke in young patients is similar to older adults. While stroke mimics may complicate suspicion and cause hesitance, delays in stroke care should be avoided. There remains a need for research in the areas of diagnosis, management, and assessment of long-term care and challenges in this population of patients.