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Review
. 2021 Jan-Dec:27:10760296211002274.
doi: 10.1177/10760296211002274.

Ischemic Stroke in the Young

Samuel A Berkman  1 , Shlee S Song  2
Affiliations
Review

Ischemic Stroke in the Young

Samuel A Berkman et al. Clin Appl Thromb Hemost. 2021 Jan-Dec.

Abstract

The purpose of this article is to address several challenging questions in the management of young patients (those age 60 and under) who present with ischemic stroke. Do genetic thrombophilic states, strongly associated with venous thrombosis, independently cause arterial events in adults? Should cases of patent foramen ovale be closed with mechanical devices in patients with cryptogenic stroke? What are the optimal treatments for cerebral vein thrombosis, carotid artery dissection, and antiphospholipid syndrome and are DOACs acceptable treatment for these indications? What is the mechanism underlying large vessel stroke in patients with COVID-19? This is a narrative review. We searched PubMed and Embase and American College of physicians Journal club database for English language articles since 2000 looking mainly at randomized clinical trials, Meta analyses, Cochran reviews as well as some research articles viewed to be cutting edge regarding anticoagulation and cerebrovascular disease. Searches were done entering cerebral vein thrombosis, carotid dissection, anticoagulation therapy and stroke, antiphospholipid antibody and stroke, stroke in young adults, cryptogenic stroke and anticoagulation, patent foramen ovale and cryptogenic stroke, COVID-19 and stroke.

Keywords: anticoagulation; cerebral; closure; stroke; thrombosis; young.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Dr Berkman is a speaker for Janssen pharmaceuticals and Alexion. Dr Song is a principal investigator for the NIH StrokeNet site at Cedars-Sinai, a GORE REDUCE co investigator and has reeived honoraria for IMPACT-LIVE CME lectures.

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