• Neuro-Ophthalmology/Orbit

    This article reports on ischemic stroke in young adults and adolescents, including incidence, risk factors, challenges of diagnosis and strategies for increasing awareness.

    The authors note that only limited prior public health and research efforts have addressed stroke in the young. Given the relative lack of high-level scientific evidence concerning stroke in this group, an evidence-based management guideline was considered unfeasible.

    Approximately 15 percent of all ischemic strokes occur in young adults and adolescents. Compared with stroke in older adults, stroke in the young has a disproportionately large economic impact by leaving victims disabled before their most productive years.

    The authors say that few studies have addressed the reasons for underdiagnosis of stroke in the young. They explain that early diagnosis remains challenging because of the lack of awareness and the relative infrequency of stroke compared with stroke mimics. Moreover, the causes of ischemic stroke in the young are heterogeneous and can be relatively uncommon, resulting in uncertainties about diagnostic evaluation and cause-specific management. However, the symptoms of ischemic stroke in young adults and adolescents are often similar to those in older patients but diagnosis can become challenging with atypical symptoms.

    Emerging data have raised public health concerns about the increasing prevalence of traditional vascular risk factors in young individuals and their potential role in increasing the risk of ischemic stroke, stroke recurrence and post-stroke mortality. The authors say that these issues make it important to formulate and enact strategies to increase both awareness and access to resources for young stroke patients, their caregivers and families, and health care professionals.

    They recommend greater emphasis on teaching about stroke in young people, including its risk factors and warning signs. They also call for greater research on reducing the physical, emotional and financial burden stroke causes in this population.

    They conclude that a national young stroke registry could improve understanding of risk factors, identify research priorities, and facilitate clinical trials of treatments and rehabilitative strategies for stroke in the young.