Stroke in young adults: a retrospective analysis.

Recent data suggest that stroke in young adults is more frequent than previously reported. To explore clinical and discharge characteristics of young adults with stroke, a retrospective chart review was completed for all young adults (ranging from 18 to 45 years of age, inclusively) admitted to this institution in 1992 with a diagnosis of stroke. The group consisted of 37 patients (mean age 36 years). The 16 men and 21 women represented 8.4% of the 441 patients with stroke treated in 1992. A total of 25 (67.6%) had ischemic strokes (37.8% cerebral infarction and 29.8% transient ischemic attacks), and 12 (32.5%) had hemorrhagic strokes (18.9% subarachnoid and 13.4% intracerebral hemorrhage). The distribution of cerebral infarction/transient ischemic attack subtypes included 16% atherothromboembolic, 32% cardiogenic, 4% lacunar, 16% other causes (such as migraine or vasculitis), and 32% of undetermined cause. Hemorrhagic stroke subtypes included 25% hypertensive, 41.6% aneurysmal, 16.7% other vascular anomalies (such as arteriovenous malformations), and 16.7% of undetermined cause. Among those who survived, 88% were discharged directly home, and 12% required rehabilitation. During the acute phase, 11% of the population died. These data suggest that strokes in young adults (1) are more frequent than previously recognized, (2) have multiple etiologic and pathologic factors, and (3) in many cases, are treatable. In general, these patients have a good prognosis.