Etiology of cerebrovascular disease in young adults

Abstract

Scientific Background: The incidence of cerebrovascular diseases (CVD) among young adults is approximately 2-11/100.000. Etiological diagnosis is very heteregenous including cardioembolism as the most common cause. Patients and Methods: Twenty-five young patients (age between 18-45 years) with cerebrovascular disease who were admitted to our University Hospital in the last two years were evaluated for their etiological diagnoses and risk factors. They were classified according to the Trial of Org 10172 in acute stroke treatment (TOAST) classification. A comparison according to gender and age was done. Results: There were ten male (40%) and fifteen female (60%) patients. The mean age of the patients was 34.7±7.8 (20-45) years. The most frequent etiological diagnosis was cardioembolism related CVD (32%). Other etiological diagnoses were: Other determined causes 24% lacunar infarct 16%, large artery atherosclerosis 4% and undetermined 24%. The most common reason for cardioembolism was valvulopathy due to rheumatic fever (75%). Comparison of risk factors amongst genders and different age groups were not statistically significant (p>0.05). Conclusion: Despite complete evaluation, etiological diagnosis can not be determined in 24% of patients. Absence of classification for young adults and insufficiency at genetic research opportunities causes important limitations in clinical evaluation.