Abstract
Introduction: Acute lacunar stroke in subjects under 55 years of age has been poorly characterized. Methods: We assessed the clinical features of lacunar stroke in 51 patients aged ≤55 years (84.5% men, mean standard deviation [SD] age 49.8 [5.2] years) collected from a prospective hospital-based stroke registry in Barcelona, Catalonia, Spain. Results: This subset of young lacunar stroke patients accounted for only 5.2% of all lacunar strokes, 1.2% of all ischemic strokes, and 1.1% of all acute strokes included in the registry over a 24-year period. In the multivariate analysis, factors independently associated with acute lacunar stroke in patients aged ≤55 years were alcohol consumption (>60 g/day) (odds ratio [OR] = 6.67), heavy smoking (>20 cigarettes/day) (OR = 3.02), obesity (OR = 2.81), essential etiology (OR = 2.73), and headache at stroke onset (OR = 2.45). Conclusion: Characterization of the clinical profile of acute lacunar stroke in younger patients contributes to a better knowledge of the full clinical expression of this ischemic stroke subtype.
Acknowledgements
We thank C Targa, E Comes, M Balcells, and M José Vidal for the care of many of the patients included in the study. This paper is dedicated to the memory of our wonderful colleague Professor J Lluis Martí Vilalta who recently passed away.
Financial & competing interests disclosure
M Pulido provided editorial assistance. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
The ischemic stroke subtype of lacunar infarcts comprises about 25% of all brain infarctions and is a common cause of dementia of vascular origin.
Lacunar stroke is mainly a disease of older patients (mean age 75.9 years in our study).
The incidence of lacunar strokes in younger adults (aged 18–55 years) was only of 5.2% of all patients with lacunar stroke.
Alcohol consumption, heavy smoking and obesity were independently associated with lacunar stroke younger patients.
Measures to correct these risk factors are particularly important strategies to prevent lacunar stroke and early subcortical vascular dementia, for which lacunar stroke has been identified as a clinically relevant risk factor.