Clinical characteristics of acute lacunar stroke in young adults

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.

Keywords:

• acute cerebrovascular event
• ischemic stroke
• lacunar infarction
• lacunar stroke
• stroke registry
• young adults

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.

Key issues

• 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.