Farrokhi won't speculate as to what caused Maureen to have a stroke. Though overweight, she wasn't obese. Nor did she have high cholesterol, diabetes, or high blood pressure. "She had no major traumas and no indication of aneurysm," says Farrokhi. "It's impossible to predict why it happened to her and not 10,000 other women in her situation." But having just given birth is a risk factor. In fact, a CDC study reports a 54 percent rise in strokes among pregnant or post-delivery women between 1994 and 2007.
Stroke in the young can be brought on by an injury to the neck--caused by random events such as car accidents, falls, and even certain yoga poses--which then leads to a tear in the vertebral or carotid artery. But researchers haven't seen a dramatic rise in these strokes. Many in the medical community feel the increase is in strokes caused by the collateral damage of drinking, smoking, and bad eating habits.
"The public health story here is that we're seeing stroke factors at much younger ages," says Kisella, the consequence "of this epidemic of childhood obesity and diabetes, and high blood pressure and cholesterol, that everyone is talking about." In other words, it's not just that today's young adults are fatter and sicklier than in years past.
Rather, because they are, they're more likely to die or become disabled.
What's notable to Dr. Mary George, who spearheaded the CDC study, is that these conditions--and thus stroke--are extremely preventable. Some 80 percent of strokes could be avoided with such lifestyle changes as exercising and eating a healthy diet, according to a Harvard School of Public Health study.
A stroke can be devastating at any age, but having one early in life presents unique recovery challenges. "Young people have a much longer life to live with their disabilities," says George, which may include speech deficits, paralysis in their arms or legs, or both. They may also be incapable of working, leaving them broke and dependent on others. George adds that her study "emphasizes the need for healthy lifestyle behavior from the time we are very young and then throughout our lives."
But even that doesn't provide total protection. Kara, a dietitian, knew how to eat well--and did. She is an avid runner and trained for a half-marathon; fit and toned, she says she felt very much like "a healthy person." She never used recreational drugs or smoked a single cigarette.
When Kara was discharged from the emergency room at NewYork–Presbyterian/Weill Cornell Medical Center the evening of the incident, she was given a handout about how to treat migraines. The possibility of a stroke hadn't been mentioned.
"For every young [stroke patient] like Kara who walks into an emergency room, doctors will see very many more patients with similar symptoms who aren't having a stroke," says her cardiologist, Jorge Kizer, M.D., an associate professor of medicine at Weill Cornell Medical College, who took over her care soon after her stroke. Still, he admits, "the fact that her arm went dead does raise a question as to why stroke was not considered. As does the fact that her mother had one at age 45"--something the hospital staff might have learned by reading the family and medical history form Kara filled out.
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