ISCHAEMIC STROKE IN THE YOUNG – MANAGEMENT

Abstract

The incidence of ischaemic stroke in young adults (18-50 years) has increased substantially in the last 3 decades, mainly because of the rising incidence of vascular risk factors in this age group (hypertension, hypercholesterolemia, diabetes mellitus, smoking, obesity) and increased illicit drugs and alcohol consumption. Although progress has been made in early diagnosis of stroke, speci fi c guidelines for the management and secondary prevention of ischaemic stroke in the young are lacking. Ischaemic stroke in young adults has a considerable socio-economic impact and is responsible for an important decrease in the labor force. While subarachnoid and intracerebral hemorrhage are more frequent in the young population, hemorrhagic stroke still remains less common than ischaemic stroke. The etiology of ischaemic stroke can be represented by non-atherosclerotic vasculopathy (arterial dissection, inherited or acquired thrombophilia) or cardioembolism in the context of patent foramen ovale and atrial septal aneurysm. In this age group, speci fi c investigations for less common causes of stroke are needed (genetic diseases, autoimmune diseases, vasculitis).