title: Young ischemic stroke in Tunisia: a multicentric study.
abstract: OBJECTIVE
  There is wanting data regarding young ischemic stroke in developing countries, especially in Tunisia. The purpose of this study was to investigate risk factors and etiologies of young ischemic stroke in Tunisian and make a comparison with previous reports.
  
  
  METHODS
  A total of 102 young ischemic stroke patients (15-45 years old) were admitted, between January 1996 and August 2007, to 11 departments of internal medicine in different Tunisian hospitals. The risk factors for stroke were documented and assessed. Diagnosis workup consisted of anamnesis, complete physical examination and extensive laboratory, radiologic, immunologic, neurologic and cardiologic examination. Stroke etiologies were classified according the Trial of ORG 10172 in acute stroke treatment.
  
  
  RESULTS
  There were 42 men (41.2%) and 60 women (58.89%) with a mean age at onset of 35.7 years. As regards stroke subtype, large-artery atherosclerosis was diagnosed in 6.9% of cases, cardioembolism in 11.8%, small-vessel occlusion in 8.8%, other determined etiology in 37.3% and undetermined etiology in 35.3%. Concerning the traditional risk factors, smoking (31.4%), hypertension and diabetes mellitus (12.7% for each one) and a family history of stroke (10.8%) were the most common. The mean follow-up period was 30.5 months.
  
  
  CONCLUSIONS
  In our study, traditional risk factors were not-so-uncommon in young adults with ischemic stroke suggesting that prevention can go through controlling these factors. Stroke of other determined etiology was the most common among our patients, so that a broad and detailed diagnostic workup is crucial to puzzle out the etiology for more and better stroke prevention.
authors.affiliation: a Department of Internal Medicine, Mongi Slim Hospital , Tunis , Tunisia , and Faculty of Medicine of Tunis , Tunis El Manar University , Tunis , Tunisia.
authors.forename: Asma
authors.initials: A
authors.lastname: Kefi
authors.affiliation: a Department of Internal Medicine, Mongi Slim Hospital , Tunis , Tunisia , and Faculty of Medicine of Tunis , Tunis El Manar University , Tunis , Tunisia.
authors.forename: Thara
authors.initials: T
authors.lastname: Larbi
authors.affiliation: a Department of Internal Medicine, Mongi Slim Hospital , Tunis , Tunisia , and Faculty of Medicine of Tunis , Tunis El Manar University , Tunis , Tunisia.
authors.forename: Meya
authors.initials: M
authors.lastname: Abdallah
authors.affiliation: a Department of Internal Medicine, Mongi Slim Hospital , Tunis , Tunisia , and Faculty of Medicine of Tunis , Tunis El Manar University , Tunis , Tunisia.
authors.forename: Amira El
authors.initials: AE
authors.lastname: Ouni
authors.affiliation: a Department of Internal Medicine, Mongi Slim Hospital , Tunis , Tunisia , and Faculty of Medicine of Tunis , Tunis El Manar University , Tunis , Tunisia.
authors.forename: Neil
authors.initials: N
authors.lastname: Bougacha
authors.affiliation: a Department of Internal Medicine, Mongi Slim Hospital , Tunis , Tunisia , and Faculty of Medicine of Tunis , Tunis El Manar University , Tunis , Tunisia.
authors.forename: Kamel
authors.initials: K
authors.lastname: Bouslama
authors.affiliation: a Department of Internal Medicine, Mongi Slim Hospital , Tunis , Tunisia , and Faculty of Medicine of Tunis , Tunis El Manar University , Tunis , Tunisia.
authors.forename: Saloua
authors.initials: S
authors.lastname: Hamzaoui
authors.affiliation: a Department of Internal Medicine, Mongi Slim Hospital , Tunis , Tunisia , and Faculty of Medicine of Tunis , Tunis El Manar University , Tunis , Tunisia.
authors.forename: Skander
authors.initials: S
authors.lastname: M'rad
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
keywords: ischemic stroke; prognosis; risk factors; young adults