Clinical - imaging features of the institutional cohort of young patients with stroke

Abstract

Stroke in younger adults is a less common event in comparison to older ones, but there have been registered a negative trend and an earlier onset of stroke in the past decades. Stroke in younger adults represents an emerging public health issue that needs strengthening, prevention, early diagnosis, and management. The aim of the present research is to investigate the clinical features, risk factors and other diagnostic findings of the young population that developed stroke.

Materials and methods: A multidirectional analysis of patients from the “Diomid Gherman” Institute of Neurology and Neurosurgery, included patients aged 18-49 years with a confirmed clinical diagnosis of stroke during the 2019-2021 period. The clinical, paraclinical, and social profiles of the patients were analyzed applying descriptive statistics.
Results: Primary stroke counted for 67,6% of the analyzed group, most of them being ischemic in the middle cerebral artery. The risk factors were cardiac rhythm dysfunctions - 83 %, hypertension - 73,2 %, obesity - 19,6 %, and diabetes - 14%. It is notable that less than half of the patients took treatment for their risk factors. Clinical features are dominated by motor deficits – 69,6 %, speech disorders - 35,7 %, and less common manifestations included alteration of consciousness or seizures. Computer tomography was used in most of the patients (87,5 %) additionally completed by magnetic resonance in 36,7%, and doppler in 78,8 to fulfill diagnostic requirements. There is a wide range of comorbidities that included hematological disorders, cancers, infections, and valvular disorders that contributed to the development of stroke in younger adults.
Conclusion: While in most cases stroke at a younger age has similar characteristics to the classic one, there are some specific trends that should be assessed during the management of the young population. The prevention of risk factors is essential for all groups of stroke patients. Specific algorithms of diagnosis and treatment would help clinicians to enhance outcomes related to stroke in younger adults.