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This study investigated arterial occlusions in young adults in Ceylon, finding atherosclerosis in men and pregnancy-related strokes in women. Dietary factors may contribute to the high incidence of atherosclerosis.
Area of Science:
- Neurology
- Vascular Medicine
- Epidemiology
Background:
- Cerebral artery occlusions in young adults are uncommon in Western populations.
- This study examines a unique cohort from rural Ceylon with distinct dietary habits.
Purpose of the Study:
- To investigate the incidence and etiology of internal carotid and middle cerebral artery occlusions in young adults.
- To explore potential risk factors, including diet, in this population.
Main Methods:
- Retrospective analysis of 44 young adults (both sexes) diagnosed with carotid or middle cerebral artery occlusions over four years.
- Clinical data review, focusing on comorbidities, diet, and pregnancy status.
Main Results:
- 19 men presented with internal carotid occlusions, primarily due to atherosclerotic thrombosis.
- 13 men had middle cerebral occlusions with obscure etiology, possibly embolism or atherothrombosis.
- 12 women experienced strokes related to pregnancy: 5 with middle cerebral artery occlusions (late pregnancy) and 2 with internal carotid artery occlusions (puerperium).
- Patients lacked traditional risk factors like hypertension, diabetes, or hypercholesterolemia.
Conclusions:
- Atherosclerosis in young men may be linked to marginal diet and carbohydrate-induced hyperlipidaemia.
- Pregnancy-related strokes in women aged 15-45 showed patterns similar to Western countries.
- Further research is needed to elucidate the obscure etiologies of middle cerebral artery occlusions in men.
Abstract:
Occlusion of the internal carotid or middle cerebral artery was seen in 44 young adults of both sexes from a rural population in Ceylon over a period of four years. None had hypertension, diabetes, prediabetes, or hypercholesterolaemia. There were 19 men with internal carotid occlusions, most being due to atherosclerotic thrombosis. The high incidence of atherosclerosis in these patients on a marginal diet remains an enigma, and we suggest that carbohydrate-induced hyperlipidaemia might be an important aetiological factor. There were 13 men with middle cerebral occlusions, the aetiology of which remains obscure. Occult embolism or atherothrombosis are suggested as possible causative factors. Of the 12 women five had middle cerebral artery occlusions in the last trimester of pregnancy and two had internal carotid artery occlusions in the puerperium. The pattern of ischaemic strokes in women aged 15-45 was similar to that observed in Western countries, though our patients differed ethnologically and in dietary habits.