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Cerebral arteriography was performed in 227 cases,and the findings were abnormal in 146.Transthoracic echocardiography revealed abnormalities in 82 of 221 patients examined.We identified approximately 60 different disorders that were presumed to be the cause of stroke.There were no major changes in the frequency of subtype diagnoses between the first 144 patients and the subsequent 185.Use of strict diagnostic criteria increased the number of cases of stroke of undetermined etiology(from 45 to 113),and the number attributed to large artery atherosclerosis declined from 71 to 32.The causes of ischemic stroke in young adults are numerous. Because treatment options in this group are influenced by a presumed cause,an evaluation on a case-by-case basis is warranted.Our experience suggests that a likely cause will be detected in most cases and that a regimented battery of tests may not be required.If strict diagnostic criteria are used,the diagnosis of stroke of undetermined etiology considerably increases.While such strict criteria are important in clinical trials that test new interventions,the value of the application of such methodologies to an unusual population,such as stroke in young adults,needs clarification.In particular,the usefulness of categorizing a stroke as undetermined when two or more possible causes are identified needs to be explored. |
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arterial dissection
cerebrovascular accident
cerebrovascular accident,cryptogenic
cerebrovascular accident,etiology
cerebrovascular accident,non atherosclerotic cause of
cerebrovascular accident,work up for
cerebrovascular accident,young adult
migraine
moyamoya
review article
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