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青年卒中:全球更新。

Stroke in the Young: a Global Update.

机构信息

Vascular Neurology Division, Department of Neurology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1366, Miami, FL, 33136, USA.

出版信息

Curr Neurol Neurosci Rep. 2019 Nov 25;19(11):91. doi: 10.1007/s11910-019-1004-1.

Abstract

PURPOSE OF REVIEW

We aim to evaluate the epidemiology, racial and gender disparity, etiology, and treatment of stroke in the younger population.

RECENT FINDINGS

The younger age group without vascular risk factors exhibits an increased prevalence of cardio-embolism in context of patent foramen ovale/atrial septal aneurysm strokes, from other determined etiology of non-atherosclerotic vasculopathy including dissection, inherited or acquired thrombophilia, and other unusual causes of stroke. Ethnic disparities also exist in certain populations. The prevalence of stroke in the young is increasing due to several factors. Since stroke is often disabling, this trend poses an enormous threat to socioeconomic stability especially in developing countries. In young patients with an absence of conventional vascular risk factors and negative preliminary stroke work-up, clinicians must consider less common causes of stroke in this population. There is prime opportunity for future investigations as there is currently a lack of evidence-based management guidelines for these uncommon etiologies based on research completed to date.

摘要

目的综述

本研究旨在评估青年人群脑卒中的流行病学特点、种族和性别差异、病因学和治疗。

最新发现

不伴有血管危险因素的年轻人群中卵圆孔未闭/房间隔瘤相关性卒中的心源性栓塞的发病率升高,而非动脉粥样硬化性血管病变的其他病因包括夹层、遗传性或获得性血栓形成倾向和其他不常见的卒中病因也较为常见。某些人群中也存在种族差异。由于多种因素,年轻人脑卒中的发病率正在增加。由于卒中常常导致残疾,这种趋势对社会经济稳定构成了巨大威胁,尤其是在发展中国家。对于没有传统血管危险因素且初步卒中检查结果为阴性的年轻患者,临床医生必须考虑该人群中卒中的少见病因。由于目前根据迄今为止完成的研究,对于这些少见病因尚未制定基于循证医学的管理指南,因此未来的研究具有重要意义。

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