Stroke in young adults in Tuzla Canton, Bosnia and Herzegovina

Abstract

Stroke in young adults accounts up to 10% of all strokes. There are a very few data about stroke in young adults in Bosnia and Herzegovina. From January 2013 to December 2015, 1836 patients with first-ever stroke were admitted at the Department of Neurology Tuzla, Bosnia and Herzegovina. We studied risk factors, stroke subtypes, severity and outcome at 1 month in all young adults (18–49 years of age). Out of total, there were 96 (5%) young adults with stroke. Mean age was 42.7 +/- 5.7 years and 40% were women. The leading risk factors in young stroke patients were hypertension (61%), followed by tobacco use (52%), hyperlipidemia (41%) and alcohol overuse (33%). Ischemic stroke was more common than hemorrhagic (55% vs. 45%), and predominantly was large artery atherosclerosis stroke type (40%). The subarachnoid hemorrhage (SAH) was more frequent than intracerebral hemorrhage (ICH) 26% vs. 19% (p = 0.01)). Stroke severity (NIHSS) at the admission was significantly lower in young stroke patients than in older ones (8.5 vs. 11.3, p = 0.01), as well as mortality at one month (8% vs. 20%, p = 0.004). Favorable outcome (modified Rankin Scale <3) had 70% of young adults compared with only 50% of patients in the older group (p = 0.0005). Stroke in young adults in Tuzla Canton is rare, and men are overrepresented. Leading risk factors in young stroke patients are hypertension and tobacco use. Severity and outcome at one month in young adults are different from those in older patients.