[Etiologic subtypes of ischemic stroke in young adults aged 18 to 45 years: a study of a series of 93 patients]. / Subtipos etiológicos de accidente cerebrovascular isquémico en adultos entre 18 y 45 años: estudio de una serie de 93 pacientes.

OBJECTIVE: This work studied the etiologic subtypes of ischemic stroke in young adults in La Coruña 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, non-arteriosclerosis 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 vasculopathy and a battery of extensive examinations is indicated to elucidate the etiology.

Subtipos etiológicos de accidente cerebrovascular isquémico en adultos entre 18 y 45 años: estudio de una serie de 93 pacientes / Etiologic subtypes of ischemic stroke in young adults aged 18 to 45 years: a study of a series of 93 patients

Objetivo. Este trabajo estudia los subtipos etiológicos de infarto cerebral isquémico en adultos jóvenes en La Coruña y hace una comparación con los resultados comunicados previamente en la literatura. Pacientes y métodos. Desde enero de 2002 hasta diciembre de 2004, un total de 2.716 infartos isquémicos, ataques isquémicos transitorios o infartos venosos cerebrales fueron ingresados en nuestro hospital; sólo 93 de ellos tenían edades comprendidas entre 18 y 45 años. El grupo de 93 pacientes fue estudiado retrospectivamente y evaluado extensamente de acuerdo a un protocolo estandarizado para analizar la distribución de los subtipos de infarto. Resultados. El infarto cerebral establecido fue diagnosticado en el 63% de los pacientes, el ataque isquémico transitorio en el 24,7% y la trombosis venosa cerebral en el 11,8%. Con respecto a los subtipos etiológicos, el infarto de etiología indeterminada fue el subtipo más común en el 37,6% de los casos, la vasculopatía no aterosclerótica se diagnosticó en el 16,1%, la etiología hematológica en el 9,7%, el cardioembolismo en el 8,6% y el infarto lacunar fue el menos común con el 4,3% de los casos. Los cuatro factores de riesgo más comunes fueron el hábito tabáquico (50,5%), la dislipemia (31,2%), la hipertensión (22,6%) y el hábito enólico (16,1%). Conclusiones. Los resultados obtenidos en nuestra serie son similares a los publicados en la literatura. El infarto cerebral establecido constituye el 63% de los casos. La probable causa de ictus isquémico fue identificada en el 63% de los casos y permanece sin explicar en el 38%. El subtipo más común fue el infarto de etiología indeterminada. La elevada incidencia no se explica por una mayor prevalencia de enfermedad aterosclerótica prematura y una serie de extensas pruebas complementarias están indicadas para llegar al diagnóstico etiológico (AU)

Otero Palleiro MM, Barbagelata López C. Subtipos etiológicos de accidente cerebrovascular isquémico en adultos entre 18 y 45 años: estudio de una serie de 93 pacientes. Rev Clin Esp. 2007;207(4):158-65. 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 Coruña 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, non-arterosclerosis 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 (AU)

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