title: Ischemic stroke in young adults: risk factors, subtypes, and prognosis.
abstract: BACKGROUND
  ischemic strokes occurring in patients younger than 47 years is a relatively rare event and accounts for less than 5% of all ischemic strokes in western countries.
  
  
  OBJECTIVE
  the etiologic spectrum in younger patients and older patients differs considerably.
  
  
  METHODS
  in this hospital case series study, we enrolled 192 patients with ischemic stroke, aged 18 to 47 years, all of whom were submitted to a diagnostic protocol. The risk factors for stroke and the distribution of stroke subtype and prognosis were studied. Modified diagnostic criteria adopted from the Trial of ORG 10172 in Acute Stroke Treatment and the Baltimore-Washington Cooperative Young Stroke Study, were used for etiologic classification.
  
  
  RESULTS
  hypertension was found to be the main risk factor (45%) followed by cigarette smoking (37%), hyperlipidemia (35.4%), diabetes mellitus (17%), and family history of stroke (18%). Hypertension, diabetes mellitus, hypercholesterolemia, and smoking were present either alone or in combination in the majority of our patients. Oral contraceptives were being taken by 25% of the women. The etiology of stroke was as follows: atherothrombosis 26.5%, cardioembolism 20%, nonatherosclerotic vasculopathies 13%, other determined causes 10%, lacunar stroke 6%, migraine 3.6%, and undetermined causes 21%.
  
  
  CONCLUSIONS
  hypertension, diabetes mellitus, hypercholesterolemia, and smoking were the most common risk factors in our ischemic stroke patients between 18-47 years of age. Health care programs targeting the prevention and treatment of these factors will reduce the associated morbidity and mortality of stroke among this socioeconomically active age group.
authors.affiliation: Department of Neurology, School of Medicine, University of Trakya, Edirne, Turkey. kemalbalcidr@yahoo.com
authors.forename: Kemal
authors.initials: K
authors.lastname: Balci
authors.forename: Ufuk
authors.initials: U
authors.lastname: Utku
authors.forename: Talip
authors.initials: T
authors.lastname: Asil
authors.forename: Yahya
authors.initials: Y
authors.lastname: Celik
mesh_terms: D000293:Adolescent; D000328:Adult; D002545:Brain Ischemia / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D002561:Cerebrovascular Disorders / Q000150:complications; D005260:Female; D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000145:classification / Q000175:diagnosis / Q000209:etiology; D055815:Young Adult