Strokes in young adults: epidemiology and prevention

Figures & data

Table 1 Studies on stroke etiology in young patients

Reference	Country	LAA	CE	SVD	ODE	UE
Cerrato et al^Citation20	Italy	16	24	17	19	24
Nedeltchev et al^Citation2	Switzerland	4	30	9	24	33
Rasura et al^Citation15	Italy	12	34	3	28	24
Varona et al^Citation3	Spain	20	18	5	22	36
Jovanovic et al^Citation21	Serbia	8	20	22	24	26
Putaala et al^Citation7	Finland	8	20	14	26	33
Spengos and Vemmos^Citation22	Greece	9	13	17	27	34
Smajlovic et al^Citation6	Bosnia and Herzegovina	15	10	26	9	40
Tancredi et al^Citation23	Italy	9	19	16	29	27
Yesilot Barlas et al^Citation24	Europe	9	17	12	22	40

Note: All numbers are percentages.

Abbreviations: LAA, large artery atherosclerosis; CE, cardiac embolism; SVD, small vessel disease; ODE, other determined etiology; UE, undetermined etiology.

Table 2 Uncommon causes of stroke in young adults

Nonatherosclerotic angiopathies	Cervicocephalic arterial dissection
	Cerebral amyloid angiopathy
	Moyamoya disease
	Fibromuscular dysplasia
	Reversible cerebral vasoconstriction syndrome
	Susac’s syndrome
	Sneddon’s syndrome
	Migraine-induced stroke
Hematologic conditions	Hypercoagulable state due to deficiencies of protein S, protein C, or antithrombin; factor V Leiden mutation, prothrombin gene G20210A mutation
	Acquired hypercoagulable state (eg, cancer, pregnancy, hormonal contraceptive use, exposure to hormonal treatments such as anabolic steroids and erythropoietin, nephrotic syndrome)
	Antiphospholipid syndrome
	Hyperhomocysteinemia
	Sickle cell disease
	Myeloproliferative disorders (eg, leukemia, lymphoma)
Genetic	Fabry disease
	CADASIL
	MELAS
	Marfan syndrome
	Neurofibromatosis
	Sturge-Weber disease
Inflammatory and infectious	Vasculitis (primary angiitis of the CNS, Sjögren syndrome, Wegener’s granulomatosis)
	Temporal arteritis
	Takayasu disease
	Behçet’s syndrome
	Neurosarcoidosis
	Neurocysticercosis
	HIV
	Varicella zoster virus
	Neurosyphilis
	Tuberculous meningitis

Abbreviations: CADASIL, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy; CNS, central nervous system; HIV, human immunodeficiency virus; MELAS, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes.

Table 3 Cardiac sources of embolism

Major risk sources	Minor risk sources
Atrial fibrillation	Patent foramen ovale
Prosthetic heart valves	Atrial septal aneurysm, recent
Myocardial infarction	Spontaneous echo contrast
Intracardiac thrombus	Mitral valve prolapse
Mitral stenosis	Mitral annular calcification
Atrial myxoma	Calcific aortic stenosis
Dilated cardiomyopathy (EF <35%)	Ventricular akinesia (EF >35%)
Left ventricular aneurysm
Infective endocarditis

Abbreviation: EF, ejection fraction.

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