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- 15% of all cases of ischemic strokes occur in patients less than 45 years old.
- To put things into perspective, incidence of stroke in this age group is twice that of multiple sclerosis.
- Delayed diagnosis is due to several factors:
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- The relative rarity of the diagnosis in comparison to stroke mimics at this age, the 3 most common being: migraines, seizures, and Bell's palsy.
- Atypical presentations, such as acute vestibular syndrome.
- Although “typical" risk factors (such as smoking, diabetes and hypertension) are present in young patients with strokes, other factors to be considered are high-risk alcohol consumption, cocaine use (especially smoked), physical inactivity, sleep 6 hours or less a night, and known thrombophilia.
References
Lo DW, Kumar R. Arterial Ischemic Stroke in Children and Young Adults. Continuum 2017; 23(1):158-180.
Singhal AB, Biller J, Elkind MS, et al. Recognition and management of stroke in young adults and adolescents. Neurology 2013;81(12):1089-1097.