Abstract
Objective: To evaluate the risk factors and etiological subtyping of ischemic stroke in young adults in the Indian population.Methods: This is a retrospective study of 160 patients, in the age group of 18 to 45 years with ischemic stroke, registered at a tertiary care hospital in Delhi, India between March 2014 and January 2018. Hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol consumption, previous history of stroke, valvular heart disease, coronary artery disease (CAD), atrial fibrillation, family history, and migraine were considered as the identifiable risk factors. Stroke subtyping was done according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria.Results: The mean age of the patients was 36.2 years with 74% being males. Headache, vomiting, difficulty in speech, and hemiparesis were the common complaints at presentation. Common risk factors identified were hypertension (50%), prior stroke or transient ischemic attack (TIA; 32%), dyslipidemia (25%), family history of stroke (18%), and smoking (15%). The most common TOAST subtype was undetermined (64%), followed by other determined cause (ODC; 20%), and cardioembolism (15%).Conclusion: There is a certain dissimilarity in the risk factors for ischemic stroke in young adults living in developing countries compared to those belonging to developed nations. Primary and secondary prevention targeted at the modifiable risk factors of ischemic stroke is necessary. Cerebral artery dissection, being a prevalent cause of ischemic stroke in young adults, should be carefully evaluated. A more appropriate stroke classification system specifically tailored for younger patients is needed.
Highlights
Stroke is the leading cause of disability in adults and is the second most common cause of death worldwide
A more appropriate stroke classification system tailored for younger patients is needed
Risk factors identified were hypertension (50%), prior stroke or transient ischemic attack (TIA; 32%), dyslipidemia (25%), family history of stroke (18%), and smoking (15%) (Table 2)
Summary
Stroke is the leading cause of disability in adults and is the second most common cause of death worldwide. About two-thirds of stroke patients belong to developing countries [1]. In India and other developing countries, young adults constitute 15%-30% of all stroke patients as compared to 3%-8.5% in the West [2]. Young adults suffering from ischemic stroke have a larger bearing on the functioning of their family, society, and country as they are in their economically most productive period. The causes of ischemic stroke in young adults are different than in the elderly. Careful evaluation of the stroke etiology is necessary for young adults to prevent recurrences
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