Nabavi D G, Allroggen A, Ringelstein E B
Klinik und Poliklinik für Neurologie, Universitätsklinikum Münster, Germany.
Nervenarzt. 2004 Feb;75(2):167-186. doi: 10.1007/s00115-003-1635-x.
Ischemic stroke in the young (age: 18-45 years) constitutes a diagnostic and therapeutic challenge. A broad spectrum of potential causes of juvenile strokes exists. Above all, nonatherosclerotic arteriopathies with dissections as their main proponent, paradoxical embolism, and thrombophilias have to be considered. Transient brief episodes with neurological deficits are difficult to discriminate from migrainous aura, epileptic seizure, psychogenic disorder. Therefore, the diagnostic work-up of juvenile stroke patients usually exceeds the amount of compulsory tests recommended in official guidelines. Various therapeutic modalities are not based on randomized large-scale studies and have to be selected on an individual basis. Despite good compliance, the annual risk of stroke recurrence is 2-3% and 1% for myocardial infarction.
青年（年龄：18 - 45岁）缺血性中风构成了诊断和治疗上的挑战。青少年中风存在多种潜在病因。首先，必须考虑以夹层为主要表现的非动脉粥样硬化性动脉病变、反常栓塞和血栓形成倾向。伴有神经功能缺损的短暂发作很难与偏头痛性先兆、癫痫发作、精神性疾病相鉴别。因此，青少年中风患者的诊断检查通常超出了官方指南推荐的强制检查量。各种治疗方式并非基于随机大规模研究，必须根据个体情况进行选择。尽管依从性良好，但中风复发的年风险为2 - 3%，心肌梗死的年风险为1%。
