Clinical Characteristics of Ischemic Stroke in Young Adults

Sinn, Dong Hyuk; Choi, Pil Cho; Song, Hyoung Gon; Jeong, Yeon Kwon

Abstract

PURPOSE
We performed this study to evaluate the clinical characteristics, including risk factors and etiologic subtypes, of ischemic stroke in young adults.
METHODS
One hundred thirty-two patients with acute ischemic stroke and between 15 and 44 years of age who visited the Emergency Department of Samsung Medical Center from January 1999 to December 2003 were included. We retrospectively reviewed their medical records and the result of brain CT, brain MRI/MRA, transcranial doppler sonography, echocardiography, electrocardiography, and laboratory studies for coagulopathy, autoimmune disease, and vasculitis according to the Young-age Stroke Protocol of Samsung Medical Center. Stroke subtypes were classified based on the TOAST criteria.
RESULTS
In this study, men (77.3%) significantly outnumbered women. The prevalence of cigarette smoking, habitual alcohol ingestion, hyperlipidemia, and DM was significantly higher in men than women. Stroke subtypes were large-artery thrombosis 26.5%, small-artery occlusive disease 20.5%, cardioembolism 17.4%, other determined etiologies 12.7%, and undetermined causes 22.7%. Among the 17 patients with other determined etiologies, arterial dissection (9 patients) was most common. Our Young-age Stroke Protocol identified a clinically significant result in only one patient.
CONCLUSION
Smoking and alcohol ingestion were the most important risk factors. The proportion of large-artery thrombosis and small-artery occlusion was relatively high compared to previous western studies. Arterial dissection was the most common cause in other determined etiologies. The current Young-age Stroke Protocol has limited value for stroke in young Korean adults.