ISCHEMIC
STROKE IN YOUNG PATIENTS : ETIOLOGIC AND
CLINICAL ASPECTS.
L.Ambrogio,
M.Coletti Moja, F.Perla, P.C.Gerbino Promis, M.G.Rosso, P.Meineri, U.Dimanico, C.La Piana,
E.Grasso.
Department of Neurology,
S.Croce Hospital, Cuneo.
Strokes in young adults (<45 years old), though not frequent,
have much interest because of their etiologic diversity and diagnosis.
In our department affered 1.478 patients with ischemic
cerebrovascular disorders (795 males, 683 females, F/M ratio 0,85, age range 18-103)
between january 1992 and november 1997; 315 of them (21%) had TIAs and 1163 strokes or
RINDs.
44 patients (2,9%) aged 18-45 ( 27 males, 17 females, F/M ratio
0,62); 14 of them had strokes, 16 TIAs, 7 (16%) arterial dissections (6 carotid and 1
vertebro-basilar), 6 venous thrombosis (VT) and 1 complicated migraine; 32 subjects had
complete recovery (73%), 10 partial recovery and 2 died (4,5%).
Trans-esophageal ecocardiography was performed in 26 cases and 16
were positive (61%): 9 patent foramen ovale (PFO), 1 PFO with interatrial sept aneurysm, 1
PFO with mitralic valvular defect, 2 with atrial thrombosis and 3 with mitralic defects.
100% of females affected by VT had oral contraceptive assumption.
As regard to plasmatic assesment of strokes and TIAs patients (29),
in 4 of them a lupic anticoagulant factor was detected, 1 had VIII factor deficiency and 1
was omocysteine positive.
We conclude that strokes in young adults have different etiologies
and that in cryptogenic strokes heart or plasm defects are often detected.
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