30^th European Pediatrics Conference

A standardized definition of “young adults” is lacking. People under 40, 45, 50 or even 55 years of age have been classified as young adults. Strokes in young adults are reported as comprise 10%–15% of all stroke patients. The nature and aetiology of stroke in young adults is different from that in older patients. Stroke in the young has a disproportionately large economic impact by leaving victims disabled before their most productive years. Recent publications report an increased incidence of stroke in young adults. Stroke was caused by atherosclerotic large artery disease in 4%, cardioembolism in 24%, small vessel disease in 9%, another determined aetiology in 30% and undetermined aetiology in 33%.

 

Modifiable risk factors for stroke, such as dyslipidemia, smoking and hypertension are highly prevalent in the young stroke population. The best form of secondary stroke prevention is directed toward stroke aetiology as well as treatment of additional risk factors. A systematic review on the incidence of stroke in young adults was published by Marini et al., who analyzed 29 studies including 3,589 patients under 45 years of age with first-ever stroke, published between 1980 and 2009. Crude rates ranged from 5.76/100,000 to 39.79/100,000. Etiologic diagnosis of stroke in young adults requires a different and more complex diagnostic work-up than that of stroke in older adults.

 

Overall, cardiac embolism and nonatherosclerotic vasculopathy are the main etiologies of cerebral infarct in younger patients.

• Arteriovenous malformation and arterial hypertension are the main etiologies of cerebral hemorrhages.

• Overall and despite thorough investigation, the causes of up to one-third of ischemias and hemorrhages remain undetermined.