Clinical Analysis Of Young Adult Stroke

Objective: To investigate the etiology factors, risk factors, clinical characters, major causes of death during hospitalization, medical complications and the prognostic conditions in young adult stroke. In order to provide clinical accordance with which we can be use to manage high risk group, prevent recurrence and improve the primary prevention of stroke.Methods: We collected 154 consecutive acute young adult stroke patients and another 154 normal persons aged in 15 to 45 years (young control group), and collected 100 acute old (over 60 years) stroke patients with random (old control group). Basic clinical information of each patient was analyzed . Univariate analysis was assessed by preliminary cross-tabulations using the x2test with SPSS 10.0 software. A logistic multiple regression model was used to determine the factors that might significantly influence the incidence of young adult stroke.Results: 1. The young adult group comprised 9.4% of patients of all ages admitted for stroke. 110 of 154 (71.4%) acute young adult stroke patients were male. 78 of 154 (50.6%) were due to cerebral hemorrhage. 2. The main etiological factors were atherosclerosis, aneurysm, arteriovenous malformation and cerebral embolism. The main risk factors were hypertension, hyperlipemia and history of cardiovascular or cerebrovascular diseases. Other risk factors such as smoking, drinking, hyperviscosaemia and family histories also contribute to the causes of young adult stroke. 3. 58 cases (37.7%) had been found more than one kinds of medical complications. Infection, heart failure, gastrointestinal bleeding and respiratory failure were associated to death in hospital. 4. The in-hospital case-fatality rate of young adult stroke patients was 9.1%. The major cause of death in hospital was respiratory and Circulatory collapse caused by brain hernia. 5. 33 cases (21.4%) with complete recovery, 68.2% partial recovery (moderately disabled but independent), and 10.4% poor recovery (severely disabled and dependent). Conclusions: 1. The percentage of stroke is higher in young adults with majority dueto cerebral hemorrhage and chiefly in male patients in our hospital. Most of the young patient's condition were serious. 2. The main etiological factors are atherosclerosis, aneurysm, arteriovenous malformation and cerebral embolism. The main risk factors are hypertension, hyperlipemia and history of cardiovascular or cerebrovascular diseases. Other risk factors such as smoking, drinking, hyperviscosaemia and family histories still contribute to the causes of young adult stroke. 3. The in-hospital mortality of the young adult stroke is less than the old group. The major cause of death in hospital was brain hernia. Medical complications are common in young adult stroke patients. How to prevent and manage medical complications are very important. For it can decrease the mortality and shortening the course of the young adult stroke. 4. Most of the cases have favorable outcome. The prevention is most important for the young adult stroke. Not only prevent the recurrences of young adult stroke patients, but also the intervention therapy to the risk factors of the high risk group should be enhanced.