What causes stroke in young patients?

Updated: Nov 30, 2018
  • Author: Andrew Danziger; Chief Editor: L Gill Naul, MD  more...
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A number of different diseases can result in ischemic stroke in the young patient. These include cardioembolic disease, dissection, inherited structural and metabolic abnormalities, thrombophilias, pregnancy, and drug use, as follows [5, 43, 44, 45] :

  • Cardioembolic strokes can be seen in patients with risk factors such as arrhythmias; congenital structural defects such as patent foramen ovale; and valvular heart disease, including both native and prosthetic valves.

  • Dissection can be seen with trauma and connective tissue disorders, such as Marfan and Ehler-Danlos syndrome.

  • Inherited abnormalities include inherited forms of hyperlipidemia, such as autosomal dominant hypercholesterolemia, cerebral autosomal dominant arteriopathy with subcortical infarcts, and leukoencephalopathy (CADASIL), and numerous other congenital metabolic abnormalities.

  • Hematologic disorders include deficiencies of protein C and S, antithrombin III deficiency, antiphospholipid antibody syndrome, hyperviscosity syndromes, and sickle cell anemia.

  • Vasculitides, including lupus and Behçet disease can also produce ischemic infarction.

  • Pregnancy creates a hypercoagulable state by increasing the amounts of certain clotting factors, with stroke and hypertensive encephalopathy being potential complications of pregnancy induced hypertension and eclampsia.

  • Drugs, both prescribed and illicit (especially cocaine), may result in ischemic infarction.

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