Ischemic Stroke in Young Adults: Profile of SARAH Hospital Brasília From 2008 to 2012

Abstract

Introduction: The societal and economic impact of ischemic stroke in young adults is considerable. The etiological investigation of ischemic stroke in this population is also challenging.

Objective: To describe the characteristics of young patients with ischemic stroke admitted to a neurological rehabilitation program in Brazil.

Methods: This transversal retrospective study analyzed data from the electronic health records of 134 patients aged 18 to 45 years with ischemic stroke admitted from 2008 to 2012.

Results: The average patient age at the time of ictus was 33 years; 56% of the subjects were female, and 29.3% had undetermined etiologies of stroke, on the basis of both TOAST and SSS TOAST criteria. Further, 48.7% of the subjects had a known vascular risk factor, which was arterial hypertension in most cases. The results of thrombophilia testing were positive in 13.7% of patients, but in only 3.7% of patients, thrombophilia was determined to be the causal mechanism of the stroke. There was a significant association between thrombophilia and patent foramen ovale, but no significant association was found between thrombophilia and arterial dissection. Among the patients with artery dissections, 46% had a history of trauma, which was statistically significant.

Conclusions: Etiological diagnosis of stroke in the young is challenging for clinicians. Hence, a more effective classification scheme, better investigative mechanisms, and correct determination of causal associations in ischemic stroke are needed. Thrombophilia screening should be performed in the presence of relevant clinical signs and/or family history.