First-ever ischemic stroke in young adult patients in a rehabilitation unit

Introduction/Background Stroke in young adults is reported as being uncommon, with recent publications reporting an increased incidence. Causes of ischemic stroke in young adults are diverse, but undetermined etiology predominates in the majority of studies. Stroke in young adults may have a dramatic impact on quality of life and economy by leaving victims disabled during their most productive years, when compared with stroke in older adults. This study aims to evaluate incidence and clinical characteristics of first-ever ischemic stroke in young patients. Material and method Retrospective analysis of patients with a first-ever ischemic stroke admitted between September 1, 2014 and June 30, 2017 in a Rehabilitation Unit. A young patient was defined as the patient with 45 or less years of age. Results One hundred and two patients with a first-ever ischemic stroke were identified, with 58.8% of male gender and with a mean age of 59.2 years old. Twelve were considered young patients (11.8%), with 8 patients of male gender (66.7%). In these patients, dyslipidemia, smoking, and hypertension were the most prevalent risk factors (33.3%, 33.3%, 16.7%, respectively). According to TOAST classification, stroke was caused by large-artery atherosclerosis in 25.0%, cardioembolism in 16.7%, small-vessel occlusion in 8.3%, another determined etiology in 16.7%, and undetermined etiology in 33.3%. According to Oxfordshire classification, half of the patients have total anterior circulation stroke, 25% partial anterior circulation stroke, 16.7% posterior circulation stroke and 8.3% lacunar stroke. NIHSS was higher in younger patients (18.5 points vs. 9 points). Conclusion Stroke in subjects under 45 years of age is not such a rare disease and is associated with high NIHSS. Given the increase incidence of stroke in young adults, there is an objective need for more research in order to reduce this social and economical burden.