Abstract
Arterial ischemic stroke (AIS) experienced at a young age is undoubtedly a serious medical problem. AIS very rarely occurs at a developmental age, whereas in young adults, it occurs with a higher frequency. The etiologic mechanisms of AIS occurring in childhood and adulthood differ. However, for both age populations, neurological consequences of AIS, including post-stroke seizures, motor disability, and recurrence of the disease, are connected to many years of care, rehabilitation, and treatment. Recurrent stroke was observed to increase the risk of patients’ mortality. One of the confirmed risk factors for recurrent stroke in children is the presence of vasculopathies, especially Moyamoya disease and syndrome, and focal cerebral arteriopathy of childhood (FCA). FCA causes a 5-fold increase in the risk of recurrent stroke in comparison with idiopathic AIS. In turn, young adults with recurrent stroke were found to more often suffer from hypertension, diabetes mellitus, or peripheral artery disease than young patients with first-ever stroke. Some reports also indicate relationships between specific genetic polymorphisms and AIS recurrence in both age groups. The aim of the present literature review was to discuss available data regarding the risk factors for recurrent AIS in children and young adults.
Highlights
Arterial ischemic stroke occurring in children and young adults is a serious medical problem.Taking into account the fact that children and young adults who survive AIS will live longer than older stroke patients, it is important to optimize the medical management for these patients and properly recognize impairments in cognition and mood, because they can be significant barriers in patients’ independent life
Understanding the risk factors for the recurrence of arterial ischemic stroke in the young may help to identify the mechanisms of AIS, especially in children, and in some cases, may contribute to disease prevention
Current knowledge on risk factors for recurrent AIS suggests that multiple risk factors may be related to stroke recurrence, both in children and young adults
Summary
Arterial ischemic stroke occurring in children and young adults is a serious medical problem. Similarity may be found in the case of a significant predominance of the male sex, both in pediatric patients with AIS and in young adults with stroke [20,21,22]. The neurological consequences of AIS, including post-stroke seizures, motor disability, and recurrence of the disease, are detrimental for both age populations They involve huge costs related to many years of care, rehabilitation, and treatment. The aim of the present literature review was to discuss and compare the available data regarding the frequency of AIS recurrence in pediatric patients and in groups of young adults, as well as to assess the possible risk factors for recurrent stroke in children and young adults. We followed data on the secondary prevention of AIS recurrence, both in children and young adults
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