Kittner S J, Stern B J, Wozniak M, Buchholz D W, Earley C J, Feeser B R, Johnson C J, Macko R F, McCarter R J, Price T R, Sherwin R, Sloan M A, Wityk R J
Department of Neurology, University of Maryland at Baltimore, MD 21201, USA.
Neurology. 1998 Apr;50(4):890-4. doi: 10.1212/wnl.50.4.890.
Few reports on stroke in young adults have included cases from all community and referral hospitals in a defined geographic region.
At 46 hospitals in Baltimore City, 5 central Maryland counties, and Washington, DC, the chart of every patient 15 to 44 years of age with a primary or secondary diagnosis of possible cerebral arterial infarction during 1988 and 1991 was abstracted. Probable and possible etiologies were assigned following written guidelines.
Of 428 first strokes, 212 (49.5%) were assigned at least one probable cause, 80 (18.7%) had no probable cause but at least one possible cause, and 136 (31.8%) had no identified probable or possible cause. Of the 212 with at least one probable cause, the distribution of etiologies was cardiac embolism (31.1%), hematologic and other (19.8%), small vessel (lacunar) disease (19.8%), nonatherosclerotic vasculopathy (11.3%), illicit drug use (9.4%), oral contraceptive use (5.2%), large artery atherosclerotic disease (3.8%), and migraine (1.4%). There were an additional 69 recurrent stroke patients.
In this hospital-based registry within a region characterized by racial/ethnic diversity, cardiac embolism, hematologic and other causes, and lacunar stroke were the most common etiologies of cerebral infarction in young adults. Nearly a third of both first and recurrent strokes had no identified cause.
关于年轻成年人中风的报道很少涵盖特定地理区域内所有社区医院和转诊医院的病例。
在巴尔的摩市、马里兰州中部5个县以及华盛顿特区的46家医院，对1988年至1991年间年龄在15至44岁、初步诊断或二次诊断为可能的脑动脉梗死的每位患者的病历进行了摘要分析。根据书面指南确定可能病因和疑似病因。
在428例首次中风病例中，212例（49.5%）被确定至少有一个疑似病因，80例（18.7%）没有疑似病因但至少有一个可能病因，136例（31.8%）未发现疑似或可能病因。在212例至少有一个疑似病因的病例中，病因分布为心脏栓塞（31.1%）、血液学及其他（19.8%）、小血管（腔隙性）疾病（19.8%）、非动脉粥样硬化性血管病（11.3%）、非法药物使用（9.4%）、口服避孕药使用（5.2%）、大动脉粥样硬化性疾病（3.8%）和偏头痛（1.4%）。另外还有69例复发性中风患者。
在这个以种族/民族多样性为特征的地区基于医院的登记系统中，心脏栓塞、血液学及其他病因以及腔隙性中风是年轻成年人脑梗死最常见的病因。首次中风和复发性中风中近三分之一未发现病因。
