Risk factors and mechanisms of stroke in young adults: The FUTURE study

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Title:	Risk factors and mechanisms of stroke in young adults: The FUTURE study
Author(s):	Alebeek, M.E. van; Arntz, R.M.; Ekker, M.S.; Synhaeve, N.E. ; Maaijwee, N.A.M.M.; Schoonderwaldt, H.C. ; Vlugt, M.J. van der ; Dijk, E.J. van ; Rutten-Jacobs, L.C.A. ; Leeuw, F.E. de
Publication year:	2018
Source:	Journal of Cerebral Blood Flow and Metabolism, vol. 38, iss. 9, (2018), pp. 1631-1641
ISSN:	0271-678X
DOI:	https://doi.org/10.1177/0271678X17707138
Publication type:	Article / Letter to editor
Please use this identifier to cite or link to this item : http://hdl.handle.net/2066/196663
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Subject:	Radboudumc 0: Other Research RIHS: Radboud Institute for Health Sciences Radboudumc 3: Disorders of movement DCMN: Donders Center for Medical Neuroscience
Organization:	Neurology Cardiology
Journal title:	Journal of Cerebral Blood Flow and Metabolism
Volume:	vol. 38
Issue:	iss. 9
Page start:	p. 1631
Page end:	p. 1641
Abstract:	Incidence of ischemic stroke and transient ischemic attack in young adults is rising. However, etiology remains unknown in 30-40% of these patients when current classification systems designed for the elderly are used. Our aim was to identify risk factors according to a pediatric approach, which might lead to both better identification of risk factors and provide a stepping stone for the understanding of disease mechanism, particularly in patients currently classified as "unknown etiology". Risk factors of 656 young stroke patients (aged 18-50) of the FUTURE study were categorized according to the "International Pediatric Stroke Study" (IPSS), with stratification on gender, age and stroke of "unknown etiology". Categorization of risk factors into >/=1 IPSS category was possible in 94% of young stroke patients. Chronic systemic conditions were more present in patients aged <35 compared to patients >/=35 (32.6% vs. 15.6%, p < 0.05). Among 226 patients classified as "stroke of unknown etiology" using TOAST, we found risk factors in 199 patients (88%) with the IPSS approach. We identified multiple risk factors linked to other mechanisms of stroke in the young than in the elderly . This can be a valuable starting point to develop an etiologic classification system specifically designed for young stroke patients.