title: Recurrence after first cerebral infarction in young adults.
abstract: OBJECTIVE
  We have investigated recurrence of stroke in a consecutive series of young adults, aged 16 to 45 years, after a first cerebral infarction.
  
  
  METHODS
  From January 1, 1988 to December 31, 1996 we submitted those patients to a diagnostic protocol including angiographic, cardiological, and haematological investigations. The patients were followed at 6 month intervals up to December 31, 1998.
  
  
  RESULTS
  We have evaluated and followed-up 135 patients, 71 men and 64 women, who were 3.99% of all the admitted stroke patients. At 12 months after stroke, 83 patients had returned to work, 40 patients were mildly to moderately handicapped, 4 were using a wheel-chair, and 8 had died. Follow-up was 26 to 123 months (mean 68.8). Recurrence of stroke, always of ischaemic nature, was seen in 15 patients (11.1%), 3 to 76 months after the first stroke (mean 27.4), for an annual incidence of 2.26%. Recurrence was significantly associated with Partial Anterior Circulation Syndrome and Haematological subtype of first stroke (respectively, P = 0.0209 and P = 0.0135, chi2 test), but not with age (< or = or > 35 years) or risk factors. Repetition of stroke was never fatal, but it caused heavy disability in 13 patients, 8 of whom had completely or nearly completely recovered after the first event.
  
  
  CONCLUSIONS
  Our data suggest that recurrence of stroke is a major clinical problem also for the patients aged less than 45 years and that it might be more frequent with specific clinical syndromes and etiologic subtypes of first stroke.
authors.affiliation: Unit of Neurology, Azienda Ospedaliera Ospedali Riuniti, Bergamo, Italy. claffra@tin.it
authors.forename: M
authors.initials: M
authors.lastname: Camerlingo
authors.forename: L
authors.initials: L
authors.lastname: Casto
authors.forename: B
authors.initials: B
authors.lastname: Censori
authors.forename: B
authors.initials: B
authors.lastname: Ferraro
authors.forename: L
authors.initials: L
authors.lastname: Caverni
authors.forename: O
authors.initials: O
authors.lastname: Manara
authors.forename: G
authors.initials: G
authors.lastname: Finazzi
authors.forename: E
authors.initials: E
authors.lastname: Radice
authors.forename: G
authors.initials: G
authors.lastname: Drago
authors.forename: S M
authors.initials: SM
authors.lastname: De Tommasi
authors.forename: E
authors.initials: E
authors.lastname: Gotti
authors.forename: T
authors.initials: T
authors.lastname: Barbui
authors.forename: A
authors.initials: A
authors.lastname: Mamoli
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D003937:Diagnosis, Differential; D004452:Echocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D005500:Follow-Up Studies; D006403:Hematologic Tests; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D020127:Recovery of Function; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed