Accident vasculaire cérébral ischémique du jeune adulte. Causes et bilan diagnostique

The incidence of ischemic stroke is rising in young adults. This rise has been concomitant with an increasing prevalence of traditional cardiovascular risk factors in young subjects. The primary cause of ischemic stroke in young adults under the age of 45 is cervical artery dissection. Large vessel atherosclerosis, small vessel disease and high-risk sources of cardioembolism are the main causes between the age of 45 and 54. Up to 50% of ischemic strokes in the young adult have no potential cause despite extensive workup. Such cryptogenic strokes include strokes with no detected cause, and strokes with a possible but uncertain cause. Non-obstructive atherosclerotic disease (stenosis < 50%), patent foramen ovale and atrial septal aneurysm are the most common uncertain causes. The role of migraine and the impact of illicit drugs are ill-defined. Many ischemic strokes in the young adult are associated with modifiable risk factors.