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Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
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Thrombophilia Screening in Young Patients With Cryptogenic Ischemic Stroke
Sofie Abels1,2, Maximillian Sihvo1, Liisa Tomppo1
1Department of Neurology (S.A., M.S., L. Tomppo, S.K., N.M.-M., L. Tulkki, J.P.), Helsinki University Hospital and University of Helsinki, Finland.
Stroke
|March 16, 2026
Summary
Over a third of young adults with cryptogenic ischemic stroke (CIS) showed thrombophilia abnormalities at baseline. Screening for thrombophilia may benefit young CIS patients with risk factors like inactivity or low HDL-cholesterol.
Area of Science:
- Neurology
- Hematology
- Genetics
Background:
- Cryptogenic ischemic stroke (CIS) incidence is rising in young adults, often without traditional vascular risk factors.
- Thrombophilia is a potential contributor to CIS, but screening guidelines vary.
- This study examines thrombophilia screening in young-onset CIS and its clinical associations.
Purpose of the Study:
- To determine the prevalence of thrombophilia screening in young adults with CIS.
- To investigate the association between thrombophilia abnormalities and clinical characteristics.
- To analyze sex-specific differences in thrombophilia screening and outcomes.
Main Methods:
- Analysis of thrombophilia panels from 556 young CIS patients (18-49 years) from the SECRETO study.
- Categorization of 10 thrombophilia markers by thrombosis risk (lowest, low, high).
- Multivariable logistic regression to identify factors associated with thrombophilia deviations.
Main Results:
- 37.1% of patients had thrombophilia abnormalities at baseline; high-risk abnormalities were rare (5.2%).
- Persistent abnormalities were found in 8.1% of patients.
- Physical inactivity, prior venous thromboembolism, low HDL-cholesterol, and low hemoglobin correlated with thrombophilia deviations.
Conclusions:
- Thrombophilia deviations are common in young adults with CIS, though high-risk cases are infrequent.
- Screening for thrombophilia may be warranted in young CIS patients presenting with specific risk factors.
- These findings aid in refining diagnostic approaches for cryptogenic stroke in younger populations.
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