103 Cases of Young Adults with Stroke: The Causes and Prognosis

ABSTRACT

Stroke in young adults are relatively uncommon. To investigate the causes, clinical findings and prognosis of cerebral infarction (CI), intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH) in young patients, we reviewed the medical records of 103 young patients(age 15-45 years) who had been admitted to Yeungnam University'Hospital from Jan. 1986 to Dec. 1990. The proportion ol young adults was 6.1% in all cerebrovascular disease patients in our hospital during the same period. The mean age was 36.38 +/- 7.27 years. About two third of the patients were older than 35 years old. The ratio of male to female patients was 1.39 to 1. The percentage of patients with ICH was 45.6%, CI, 37.9%, and SAH, 16.5%. The causes of cerebral infarction were atherosclerosis (38.4%), cardiogenic cause (28.2%), nonatherosclero tic vasculopathy (10.3%), and hematologic abnormality (7.7%) in order of frequency, and the most involoved site was the carotid territories (79.4%). The major causes of intracerebral hemorrhage were hypertension (59.6%) and arteriovenous malformation (8.5%). The locations of the hematoma on brain CT scan were the basal ganglia (42 5%), lobe (34%), thalamus (8.5%), pons (6.4%) and ventricle (4.3%) in that order of frequency. Subarachnoid hemorrhage was mainly due to ruptured aneurysm (76.4%). Undetermined causes noted in 15 cases (14.6%). The overall mortality of this group of patients was 23.3%. Most of the patients (83.3%) with fatal outcome died within the first 2 weeks. The degree of neurologic sequelae among survivors was mild (45.6%) to moderate (22.3%).