Cerebral infarction in patients aged 15 to 40 years

Cerebral infarction among young adults has been little studied in Brazil. Most studies adopt a variable upper age limit and often use the term "young" to designate different age ranges. The objective of the present study was to determine possible differences in etiology of cerebral infarction in specific age subpopulations.

We studied 106 patients aged 15 to 40 years and divided them into two subpopulations by age at time of ictus (ie, 15 to 29 years and 30 to 40 years). On the basis of Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria, we classified the patients into the following five groups: (1) large-artery atherosclerosis, (2) small-vessel occlusion or lacunae, (3) cardioembolism, (4) other determined causes, and (5) undetermined causes. The proportions for each group were compared between the two age ranges to determine whether there was a significant difference in group distribution.

The proportions were different between the two age ranges, with a predominance of women and TOAST-criterion group 4 in the 15- to 29-year age range. In the 30- to 40-year age range, there was a predominance of men and of TOAST-criterion group 3.

The proportions of the groups in the two age ranges were significantly different for lacunar infarctions and infarctions of other etiologies. This observation suggests that different age ranges present characteristically different distributions and therefore should be considered separately when investigated. The older age range already presents features that suggest a transition to the spectrum observed among the aged.