Stroke in young

Stroke in people under 45 years of age is less frequent than in older populations but has a major impact on the individual and society. In this article we provide an overview of the epidemiology and etiology of young stroke.Cerebral ischemia in young adults occurs at an annual incidence rate of about 6/100,000. Although it represents only about 1% of all strokes, it has a relevant impact on years of potential life lost and on socioeconomic costs, considering the long life expectancy at these ages. There is general agreement on the role of atherosclerosis in men over age 35 and of cardiac diseases, migraine, and oral contraceptive use in women under age 35 as pathogenic determinants for cerebral ischemia. Whether the early onset of stroke in young adults might reflect severity of underlying pathology is still an open question. The short-term prognosis of stroke in young adults is considered favorable, despite its relationship with the presence and severity of complications at the time of the first event. Long-term prognosis of young patients with transient ischemic attack is reported to be even more favorable, although the risk of new ischemic events depends on the presence of vascular risk factors. The available prospective studies report annual incidence rates of death and recurrent stroke ranging from 1% to 2.6%, with higher long-term mortality in patients who had large-vessel stroke. The prognosis has been reported to be severe in patients with carotid stenosis and mild in patients with coexisting stroke and migraine.