Epidemiology and Etiology of Ischemic Stroke in Young Adults Aged 18 to 44 Years in Northern Sweden

• DOI: 10.1161/01.str.28.9.1702
• Publication Date: 2011-06-17T20:08:03Z
• Authors: Bo Kristensen; Jan Malm; Bo Carlberg; Birgitta Stegmayr; Christer Backman; Markku Fagerlund; Tommy Olsson
• Keywords: Etiology; Stroke; Case fatality rate

Background and Purpose The aim of this study was to conduct a population-based epidemiological survey among young adults aged 18 44 years in Northern Sweden furthermore gain further insight into the etiology ischemic stroke age group. Methods Two studies were done. In first part, data collected calculate incidence mortality from 1991 through 1994. This based on World Health Organization MONICA register acute events. Eighty-eight first-ever patients identified during that period. second 107 consecutive with referred university hospital studied prospectively 5-year period extensively evaluated according standardized protocol. On basis modified Trial ORG 10172 Acute Stroke Treatment (TOAST) criteria, classified eight subtypes stroke. Results average annual rate for (cases per 100 000 year) 11.3 (95% confidence interval, 6.7 16.1). case-fatality 5.7%. According TOAST probable cause 36% remained unexplained 21% cases. Spontaneous cervical arterial dissection leading (13%). Patent foramen ovale or atrial septal aneurysm possible 28% percentages attributed IgG anticardiolipin antibodies (4.7%), atherothrombotic vasculopathy (3.7%), oral contraceptive use (7%), migraine (1%) lower than reported recent clinical series. Conclusions higher previously most countries Western Europe. not explained by prevalence premature atherosclerotic vasculopathy. Without additional diagnostic information derived advanced cardiac imaging, proportion indeterminate cases would have constituted 37% patients.