Stroke in the young in Israel. Incidence and outcomes

Data on stroke in the young in Israel are fragmentary. To obtain an overall perspective and to assess the nature and magnitude of the problem, a study was conducted on stroke occurrence in the young population during 1 year. Incidence and outcomes are reported in this communication.

We conducted a prospective ascertainment of first stroke in all permanent residents of Israel aged 17 to 49 years who were referred to all acute-care hospitals in the country or died before reaching them.

We identified 253 first stroke victims in the studied population; 62.8% were male. The age- and sex-adjusted incidence rate for all types of stroke was 10.36/100 000 per year (males, 13.00; females, 7.71). The majority of strokes (80.6%) were cerebral infarctions, with 9.9% intracerebral hemorrhages, 7.9% subarachnoid hemorrhages, and 1.6% strokes of unspecified type. The case-fatality rate for all types of stroke was 9.9% (mortality within the first 4 weeks after the event, on average 6 days). The survival rate was 95% for cerebral infarctions, 64% for intracerebral hemorrhages, and 80% for subarachnoid hemorrhages; 86.7% of all survivors remained with an impairment resulting in a disability.

Incidence rates were similar to those reported from developed Western countries. The case-fatality rate of 9.9% and the considerable percentage of survivors with a disability in a population at the beginning of their family, professional, and social lives indicate the magnitude of the problem.