Cerebral infarction in young women: analysis of 130 cases

Abstract

The aim of this study was to determine the risk factors and mechanism of cerebral infarction in young women.

Methods: We evaluated 130 consecutive women younger than 41 years of age with cerebral infarction and compared the risk factors with a control group of 122 healthy, age-matched women.

Results: The leading risk factors in patients with cerebral infarction were migraine (15%), tobacco use (15%), and oral contraceptive (OC) use (12%). Cerebral arteriograms were abnormal in 59% of patients (57 of 96). The causes of cerebral infarction were cardiac embolism in 36%, nonatherosclerotic vasculopathy in 25%, hematologic disorders in 8%, and migraine in 8%. The etiology could not be determined in 23% of patients.

Conclusion: Migraine and OCs are independent risk factors for cerebral infarction in young women. The leading etiologies were rheumatic valve disease and nonatherosclerotic vasculopathy, hematologic disturbances, and migraine were responsible for a few cases.

PIP: This study examines the risk factors and mechanism of cerebral infarction in 130 women younger than 41 years of age with cerebral infarction. A control group of 122 healthy, age-matched women were used for comparison. Each patient underwent the following: complete blood count, biochemical profile, lipid profile, venereal disease laboratory test, erythrocyte sedimentation rate, and rheumatologic profile (rheumatoid factor, antinuclear antibodies, anti-DNA, C-reactive protein). All patients underwent computed tomography or magnetic resonance imaging, transthoracic or transesophageal echocardiography; while transcranial Doppler or sonography of vessels of the neck and cerebral angiography were performed electively. The results of evaluation revealed that the leading factors among patients with cerebral infarction were migraine (15%), tobacco use (15%), and oral contraceptive (OC) use (12%). Cerebral arteriograms were abnormal in 59% of patients. The causes of cerebral infarction were cardiac embolism (36%), nonatherosclerotic vasculopathy (25%), hematologic disorders (8%), and migraine (8%). The etiology could not be determined in 23% of patients. Migraine and OCs were considered as independent risk factors for cerebral infarction in young women.