Bukhari Syed, Yaghi Shadi, Bashir Zubair
Temple University Hospital, Philadelphia, PA 19140, USA.
Department of Medicine, Brown University, Providence, RI 02912, USA.
J Clin Med. 2023 Jul 29;12(15):4999. doi: 10.3390/jcm12154999.
Stroke in young adults is associated with significant morbidity, and its prevalence is rising in the United States. This is partly attributed to a rise in the prevalence of traditional risk factors including hypertension, hypercholesterolemia, obesity, diabetes mellitus, smoking and heart disease. In addition, there are non-modifiable risk factors comprising migraine, pregnancy and postpartum state, illicit drug use, oral contraceptives and hypercoagulable state. The mechanisms causing stroke in young adults are unique and include cervical dissection, cardioembolic phenomenon, vasculitis and vasculopathy, connective tissue disease, patent foramen ovale and cerebral venous thrombosis. The diagnosis of stroke in the young population can be challenging given its myriad clinical presentations. In this document, we provide an overview of the epidemiology of stroke in young adults, explore mechanisms that may explain increasing rates of stroke in this population, and provide a critical updated overview of the existing literature on the management and prevention of stroke in young adults.
年轻成年人中风与显著的发病率相关，且在美国其患病率正在上升。这部分归因于包括高血压、高胆固醇血症、肥胖、糖尿病、吸烟和心脏病在内的传统风险因素患病率的上升。此外，还有不可改变的风险因素，包括偏头痛、妊娠和产后状态、非法药物使用、口服避孕药和高凝状态。导致年轻成年人中风的机制独特，包括颈动脉夹层、心源性栓塞现象、血管炎和血管病、结缔组织病、卵圆孔未闭和脑静脉血栓形成。鉴于其众多的临床表现，年轻人群中风的诊断可能具有挑战性。在本文件中，我们概述了年轻成年人中风的流行病学，探讨了可能解释该人群中风发病率上升的机制，并对现有关于年轻成年人中风管理和预防的文献进行了重要的更新概述。
