Stroke in Young Adults

ABSTRACT

Stroke in young adults are not common and it is often hard to find their causes. We reviewed the medical records of 154 young adult patients aged 15-45 years who were admitted to the Seoul National Urliversity Hospital with a diagnosis of stroke between March 1989 and February 1991. These cases comprised 13.8% of 1115 patients of all ages admitted for stroke. The number of young adult patients with intracerebral hemorrhage was 47 (30.5%, N&154); the main causes were hypertension, arteriovenous malformation, and moyamoya disease. Subarachnoid hemorrhage was found in 25 young patients (l6.2%, N=154); the majority were due to aneurysms. The number of intraventricular hemorrhage cases was 17 (11.0%, N&154). The causes confirmed by angiography, were moyamoya disease in 7 cases and arteriovenous malformahon in 5 cases. The remaining 73 patients (47.4%, N&154) had cerebral infarction;the major causes were young-aged atherosclerosis (75.3%) and cardiogenic emboli (24.7%). Hypertension, history of transient ischemic attack, and hyperlipidemia were major risk factors of atherosclerotic cerebral infarction. Among the cerebral infarction patients whose risk factors had not been found by conventional diagnostic methods (l6 patients), there were 5 patients in whom the presence of cardiac embolic sources could be demonstrated only by transesophageal echocardiography (left atrial thrombus in two patients; patent foramen ovale in two; and atrial septal aneurvsm in one patient). The total number of all tvpes of young adult stroke patients whose causes (or risk factors) were unable to be classified in detail was 24 (15.6%, N&154). The transesophageal echocardiography and the angiography, in many occasions, were helpful in detecting the causes of young adult stroke of which risk factors had been undetermined.