Accidents vasculaires cerebraux ischemiques du sujet jeune

ABSTRACT

Objectives The purpose of this study was to determine etiologies and outcome of strokes in young adults. Patients and methods We studied retrospectively 48 cases of patients with transient ischemic attack or arterial ischemic stroke aged between 15 and 48 years admitted in the Neurology and Cardiology Departments of the University Hospital of Monastir from 1987 to 1996. The study variables included the full clinical spectrum, spanning historical, laboratory, radiological and outcome parameters. Results Thirty four were female and 14 male, the mean age was 33 +/- 8,8 years, with a peak in the 4th decade. Our series is caracterised by the higher incidence of cardioembolic dominated by prosthetic valve. 62,5% of patients had common vascular risk factors. Non-atherosclerotic arteriopathies were observed in six cases uncommun etiologies of ischemic stroke [Moya-Moya disease, Tokayasu's disease] Etiology remain indeterminated in four cases. Mortality rate was 8,5%. Reccurrences were observed in 12,5%. 29% of patients have recovered a complete autonomy while 26% have conserved severe handicap. Conclusion We found a higher incidence of cardioembolic diseases dominated by prosthetic valve