Pathogenesis of Stroke in Young Adults
The lower and upper limits of age that define a young adult with stroke are rather arbitrary. By convention the age span in this situation is usually set in the range of 15–18 years up to 45–50 years of age. The definition of this range is useful and justified by differences in etiologies, evaluation and prognosis in this younger population as compared with stroke in the elderly. Defining the diagnosis and cause of stroke in the young is often a challenging task. The causes of stroke among young adults are more diverse than in the elderly and require an extensive diagnostic workup. Bogousslaysky and Pierre  listed up to 120 causes of stroke in the young and some authors [2, 3] also provided guidelines for clinical management of both commonly and rarely encountered cerebrovascular disorders in young adults. Hower, it is difficult to give an accurate hierarchy of causes of stroke based on their frequency because most studies come from secondary or tertiary care centers so that the results are invariably biased toward uncommon causes. Yet, the etiology or the underlying disorder of approximately one third of ischemic stroke remains undetermined. Table 1 shows the potential causes of ischemic stroke in young adults.
KeywordsIschemic Stroke Infective Endocarditis Arterial Dissection Paradoxical Embolism Atrial Septal Aneurysm
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- 1.Bogousslaysky J, Pierre P (1992) Ischemic stroke in patients under 45. Neurol Clin 10: 113–124Google Scholar
- 3.Caplan LR (1993) Stroke in children and young adults. In: Stroke. A clinical approach. 2nd edn. Butterworth-Heinemann, Boston, MA, pp 469–485Google Scholar
- 5.Biller J (1994) Atherosclerotic cerebral infarction in young adults. In: Stroke in children and young adults. Butterworth-Heinemann, Boston, MA, pp 45–56Google Scholar
- 7.Labovitz AJ, Pearson AC (1993) Cardiac masses and cardiac source of emboli. In: Trans-esophageal echocardiography: basic principle and clinical applications. Lea & Febiger, Philadelphia, London, pp 106–116Google Scholar
- 10.Cabanes L, Mas JL, Cohen A et al (1993) Atrial septal aneurysm and patent foramen ovale as risk factors for cryptogenic stroke in patients less than 55 years of age. A study using trans-esophageal echocardiography. Stroke 24: 1865–1873Google Scholar
- 13.Cook PJ, Honeybourne D, Lip GYH et al (1998) Chlamydia pneumoniae antibody titers are significantly associated with acute stroke and transient cerebral ischemia. The West Birmingham Stroke Project. Stroke 29: 404–410Google Scholar
- 14.Hart RG, Kanter MC (1990) Hematological disorders and ischemic stroke. A selective review. Stroke 21: 1111–1121Google Scholar
- 18.Henderson GV, Kittner SJ, Johns DR (1997) An incidence study of stroke secondary to Melas in the young. Neurology 49: A439Google Scholar
- 22.Headache Classification Committee of the International Headache Society (1998) Classification and diagnostic criteria for headache disorders, cranial neuralgias and facial pain. Cephalgia 8 [Suppl 7]: 13Google Scholar