Evident risk factors for younger stroke patients in Taiwan.

Risk factors for stroke in the young are often different from those in older patients. Since a rather high incidence of stroke exists in Taiwan, we prospectively studied risk factors in 208 stroke patients aged between 15 and 45 years seen in four main hospitals in Taiwan from 1986 to 1993. Of the 116 patients with cerebral infarction, 48 (41.4%) had related premature atherosclerosis mainly caused by hypertension (18.1%), hyperlipidemia (4.3%), and diabetes mellitus (3.4%). Thirty-four patients (29.3%) had an identifiable predisposing factor of cardiac origin including valvular diseases. In 92 patients with cerebral hemorrhage, hypertension was present in 30 patients (32.6%) and a vascular malformation of brain in 21 patients (22.8%). For a specific district in Taiwan, the major risk factors for strokes in younger patients were hypertension, rheumatic heart disease, and vascular malformation of brain. Cardiac and neuroradiologic investigations are particularly indicative, and clinical effort in the management of these treatable causes needs emphasis.