A Contemporary Review of Epidemiology, Risk Factors, Etiology, and Outcomes of Premature Stroke

Abstract

Purpose of review: Recent data identifies increases in young ischemic and hemorrhagic strokes. We provide a contemporary overview of current literature on stroke among young patients or premature stroke along with directions for future investigation.

Recent findings: Strokes in the young are highly heterogenous and often cryptogenic. Sex distribution and risk factors shift from women among the youngest age groups (< 35) to men over the age of 45, with a coinciding rise in traditional vascular risk factors. Incidence is higher in minority and socioeconomically disadvantaged populations, and the impact of stroke among these communities may be exaggerated by disparities in symptom recognition and access to care. Special diagnostic work-up may be needed, and a lower threshold for diagnosis is warranted as potential misdiagnosis is a concern and may preclude necessary triage and management. Although "premature strokes" form a relatively small proportion of total incidence, they vary greatly across subgroups and present an outsized impact on quality of life and productivity.

Keywords: Intracerebral hemorrhage; Ischemic stroke; Stroke epidemiology; Stroke etiology; Stroke outcomes; Young stroke.

Fig. 1

Overview of major risk factors and characteristics of premature stroke across the age ranges where they are most prominent