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Strokes in young adults are uncommon and often a diagnostic challenge.A retrospective study of strokes due to intracerebral hemorrhage, subarachnoid hemorrhage,or cerebral infarction was undertaken.We reviewed the medical records of 113 young patients aged 15-45 years who were admitted to the Medical Center Hospital of Vermont with a diagnosis of stroke between 1982 and 1987.This group comprised 8.5%of patients of all ages admitted for stroke,2.3 times the proportion observed in the National Survey of Stroke.Nontraumatic intracerebral hemorrhage was diagnosed in 46 young patients(41%);the main causes included aneurysms,arteriovenous malformations,hypertension,and tumors.Subarachnoid hemorrhage was found in 19 young patients(17%);the majority were due to aneurysms.The remaining 48 young patients(42%)had cerebral infarction,the majority due to cardiogenic emboli and premature atherosclerosis.Mitral valve prolapse,the use of oral contraceptives,alcohol drinking,and migraine were infrequent sole causes of cerebral infarction in the absence of other risk factors.The case- fatality rate for this group of young patients with stroke was 20.4% compared with 23.9%for the National Survey of Stroke.Young adults with stroke deserve an extensive but tailored evaluation,which should include angiography and echocardiography. |
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aneurysm
aneurysm,intracranial
angiography,cerebral
atherosclerosis,premature
carotid artery atherosclerosis
cerebral atherosclerosis
cerebral embolism
cerebral embolism,cardiac origin
cerebrovascular accident
cerebrovascular accident,non atherosclerotic cause of
cerebrovascular accident,young adult
cerebrovascular disease,premature
echocardiogram
embolism
intracerebral hemorrhage
intracerebral hemorrhage,young adult
malformation,vascular
malformation,vascular,cerebral
mitral valve prolapse
mortality
prognosis
review article
subarachnoid hemorrhage
thrombus,mural
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