Martin P J, Enevoldson T P, Humphrey P R
Department of Neurology, Walton Centre for Neurology and Neurosurgery, Liverpool, UK.
Postgrad Med J. 1997 Jan;73(855):8-16. doi: 10.1136/pgmj.73.855.8.
The causes of ischaemic stroke in young adults are many and diverse. Such patients usually require more extensive investigations in order to find an underlying cause than more elderly patients. It is important that a comprehensive search is made since many of the underlying disorders are treatable. Principal causes are extracranial arterial dissection, cardioembolism, premature atherosclerosis, haematological and immunological disorders and migraine. Drug abuse is becoming increasingly important but the risk of stroke in pregnancy remains unclear. Isolated angiitis of the central nervous system, heritable disorders of connective tissue and other genetically determined disorders (mitochondrial cytopathies, CA-DASIL) account for a small proportion of ischaemic strokes in the young. Management is probably best undertaken by a physician with a specialist interest and, if full investigation fails to elucidate a definite cause, the risk of future stoke is low.
青年缺血性卒中的病因多种多样。与老年患者相比，这类患者通常需要更广泛的检查以找出潜在病因。进行全面排查很重要，因为许多潜在疾病是可治疗的。主要病因包括颅外动脉夹层、心源性栓塞、早发性动脉粥样硬化、血液学和免疫学疾病以及偏头痛。药物滥用正变得越来越重要，但孕期卒中风险仍不明确。中枢神经系统孤立性血管炎、结缔组织遗传性疾病以及其他基因决定的疾病（线粒体细胞病、伴皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病）在青年缺血性卒中中占比很小。治疗最好由有专业兴趣的医生进行，如果全面检查未能明确病因，未来发生卒中的风险较低。
