Stroke in young patients: a diagnostic challenge in the emergency room.
Stroke in young adults has been related to mechanisms different to those found in older individuals. Cardiogenic embolism, arteritis, atherosclerosis, fibromuscular dysplasia, pregnancy-related angiopathy, migrainous stroke, anaemia, antiphospholipid syndrome, arterial dissection, the consumption of toxic substances and head trauma have been described. We present a young man with a case history of tobacco and cocaine abuse who suffered a mild head trauma, with normal neurological examination, and a computed tomography scan image of a right anterior cerebral infarction. Serum biochemistry showed no alterations according to the diagnosis protocol for stroke in young patients. Various mechanisms have been involved, such as vasospasm, increasing arterial pressure and embolism. Considering the cocaine abuse and the mild head trauma, in our patient vasospasm was thought to be the mechanism involved in the cerebral infarction, which proved a challenge to diagnose in the emergency room.
González-Martínez
Felix
F
Department of Emergency Medicine, Hospital Virgen de la Luz, Cuenca, Spain. fgonmar@mailpersonal.com
Navarro-Gutiérrez
Sergio
S
Oliete-Ramírez
Elena
E
Sánchez-Yépez
Jeannet
J
Ballester-Vidal
María Rosa
MR
Estévez-Rovira
Enric
E
D000328:Adult; D004632:Emergency Medical Services / Q000379:methods*; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D008297:Male; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology; D019966:Substance-Related Disorders / Q000150:complications
D005343:Fibrinolytic Agents