Young Stroke Victims
Feb 25 -- While it is true that strokes are more common in the elderly, they can occur in young adults, and even in adolescents and children. "Young stroke" in medical research generally refers to patients under the age of 50.
In many patients, particularly in the 40-50 year old range, strokes are due to premature atherosclerosis, the same disease which causes heart attack and "hardening of the arteries."
These patients typically have risk factors for atherosclerosis, such as hypertension, diabetes, smoking and elevated cholesterol. Often there is a family history of stroke or heart disease at a young age.
African-Americans are several times more likely to have a stroke at a young age than whites, even if risk factors are taken into account. The reason for this difference is not known.
Strokes can also occur in young patients without risk factors for atherosclerosis, but the causes are diverse and can be difficult to diagnose given the uncommon nature of these diseases.
In the evaluation of a young stroke patient, physicians evaluate three basic areas to determine the cause: the heart, the blood vessels supplying the brain, and the blood clotting system.
The Heart
Congenital heart disease is a leading cause of stroke in children. People with artificial heart valves must often be kept on anticoagulants ("blood thinners") to prevent clots from forming on the valves.
Other heart conditions, such as mitral valve prolapse, may produce clots, but these are infrequent and can usually be managed with medicines such as aspirin effectively.
Infection of a heart valve, referred to as endocarditis, is a serious medical condition that can cause bits of infected clot to travel to the brain, causing both stroke and aneurysms.
Endocarditis can occur in patients with damaged heart valves (e.g. with a history of rheumatic fever) or can occur on normal valves in people who abuse intravenous drugs using contaminated needles or non-sterile substances.
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