Journal
JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM
Volume 38, Issue 9, Pages 1631-1641Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/0271678X17707138
Keywords
Etiology; ischemic stroke; risk factors; transient ischemic attack; young stroke
Categories
Funding
- Dutch Heart Foundation [2014T060]
- VIDI innovational grant from The Netherlands Organisation for Health Research and Development ZonMw [016-126-351]
- Dutch Epilepsy Fund [2010-18]
- British Heart Foundation [FS/15/61/31626]
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Incidence of ischemic stroke and transient ischemic attack in young adults is rising. However, etiology remains unknown in 30-40% of these patients when current classification systems designed for the elderly are used. Our aim was to identify risk factors according to a pediatric approach, which might lead to both better identification of risk factors and provide a stepping stone for the understanding of disease mechanism, particularly in patients currently classified as unknown etiology. Risk factors of 656 young stroke patients (aged 18-50) of the FUTURE study were categorized according to the International Pediatric Stroke Study (IPSS), with stratification on gender, age and stroke of unknown etiology. Categorization of risk factors into >= 1 IPSS category was possible in 94% of young stroke patients. Chronic systemic conditions were more present in patients aged <35 compared to patients >= 35 (32.6% vs. 15.6%, p < 0.05). Among 226 patients classified as stroke of unknown etiology using TOAST, we found risk factors in 199 patients (88%) with the IPSS approach. We identified multiple risk factors linked to other mechanisms of stroke in the young than in the elderly. This can be a valuable starting point to develop an etiologic classification system specifically designed for young stroke patients.
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