Etiologic subtypes of ischemic stroke in young adults aged 18 to 45 years:: a study of a serie of 93 patients

Objective. This work studied the etiologic subtypes of ischemic stroke in young adults in La Coruna and compared this with previous reports. Patients and methods. From January 2002 to December 2004, a total of 2716 patients with ischemic cerebral infarcts, transient ischemic accidents or venous infarcts were admitted in our hospital. Only 93 patients were between 18 to 45 years old. This group of 93 patients was studied retrospectively and was extensively evaluated according to a standardized protocol to analyze the distribution of stroke subtypes. Results. Cerebral infarction was diagnosed in 63%, transient ischemic attack in 24.7% and venous infarction in 11.8% of the cases. Regarding stroke subtype, stroke of undetermined etiology was the most common subtype diagnosed in 37.6% of cases, nonarterosclerosis vasculopathy in 16.1%. hematology etiology in 9.7%. cardioembolism in 8.6% and stroke of small-vessel occlusion was the least common in 4.3%. The four most common risk factors were smoking (50.5%), hyperlipidemia (31.2%) and hypertension (22.6%) and alcoholism (16.1%). Conclusions. The results obtained in our series are similar to those published in the literature. Cerebral infarct accounted for 63% of the cases. A probable cause of ischemic stroke was identified en 62% and remained unexplained in 38% of the cases. Stroke of undetermined etiology was the most common subtype. The high incidence was not explained by a higher prevalence of premature atherosclerotic vasculopaty and a battery of extensive examinations is indicated to elucidate the etiology.