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Lancet Neurol. 2018 Sep;17(9):790-801. doi: 10.1016/S1474-4422(18)30233-3.

Epidemiology, aetiology, and management of ischaemic stroke in young adults.

Author information

1
Department of Neurology, Donders Institute for Brain Cognition and Behaviour, Radboudumc, Nijmegen, Netherlands.
2
Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
3
Division of Neurology, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
4
Team VINTAGE, Bordeaux Population Health Research Centre, Inserm, University of Bordeaux, Bordeaux, France; Memory Clinic, Department of Neurology and Institute for Neurodegenerative Diseases, CHU de Bordeaux, Bordeaux, France.
5
Department of Neurology, Donders Institute for Brain Cognition and Behaviour, Radboudumc, Nijmegen, Netherlands. Electronic address: frankerik.deleeuw@radboudumc.nl.

Abstract

Epidemiological evidence suggests that the incidence of ischaemic stroke in young adults (18-50 years) has increased substantially. These patients have a long life expectancy after stroke, and the costs of long-term care pose huge challenges to health-care systems. Although the current recommendations for treatment of young and old (>50 years) patients with stroke are similar, the optimal management of young adult patients with stroke is unknown. They are usually not included in trials, and specific subanalyses limited to young adult patients with stroke are usually not done, owing to lower incidence of stroke and lower prevalence of vascular risk factors in young adults. Progress has been made in identifying patients with a considerable risk of stroke occurrence, such as those with patent foramen ovale. Future prevention studies might result in a decrease in the incidence of stroke and its sequelae in young adults. The development of guidelines specifically devoted to the management of stroke in young adults will be an important step in achieving this aim.

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