AN ETIOLOGICAL STUDY OF ISCHEMIC STROKE IN YOUNG ADULTS.

Background:- Ischemic stroke in young adult accounts for up to 12% of all first ever ischemic strokes. Cardioembolic source has been shown to be the most frequent cause of ischemic stroke in young population. Objective:-To determine the different etiologies and risk factors of ischemic stroke in young adults. Patients and methods:-The present descriptive study was performed on 40 patients presented by cerebral ischemic stroke whose age was ranged between 20-42 years. After detailed history and examination, all patients underwent standard diagnostic investigations. The laboratory investigations included complete blood counts (CBC), ESR, urine examination, liver function tests, lipid profile and renal function tests. Thrombophilia screening and protein C&S assay were performed in patients when indicated. Electrocardiogram (ECG), echocardiogram, carotid duplex ultrasound study, imaging studies of brain including CT scan and/or magnetic resonance imaging (MRI), were carried out routinely in all patients. Results:-There was an overall female preponderance (F/M ratio 1.2/1). Cardioembolism was the most frequent cause of young stroke (32.5%), followed by stroke due to large artery athero¬sclerosis (27.5%). Small vessel disease (15%), determined etiology (12.5%) and stroke due to undetermined etiology (12.5%) were least frequent etiologic patterns.Smoking, hypertension and dyslipidemia were statisti-cally significantly associated risk factors in this series of younger stroke patients. Conclusion:-Cardioembolic etiology is the most common treatable subtype of stroke in young adults and traditional risk factors i.e. hypertension, diabetes mellitus, dyslipidemia and cigarette smoking are the most important risk factors associated with ischemic stroke in young adults.