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Stroke in Young Patients - A New Trend in Nepalese Perspective?

Pokharel BR, Kharel G, Thapa LJ and Rana PVS

Background: Stroke is caused by the loss of blood supply to the brain, commonly known as cerebral vascular accident (CVA). Strokes in younger people (below 45 years) are not common as it usually occurs in the middle-aged and elderly. The absolute definition of stroke in young does not exist, however conventionally “young stroke” is considered for people below 45 years.

Objective: To analyse the trends in occurrence, risk factors, etiology and neuroimaging features of ischemic stroke in young adults.

Methods: In this study the records of 281 strokes patients were reviewed, out of which 33 were young patients admitted to Neurology ward of College of Medical Sciences, Bharatpur, Nepal from 1st January to 31st December 2013. The records were analysed on the basis of age, sex, hypertension (HTN), body mass index (BMI), smoking habits, haemoglobin (Hb), diabetes mellitus (DM), lipid profile, atrial fibrillation (AF) and vascular territory with clinical and radiological evidences.

Results: Most of the young stroke patients were between 40-45 years. Ischemic stroke was noted in 87.8%and haemorrhagic stroke was noted in 12.2% of patients. Middle cerebral artery (MCA) ischemia was noted in 57.6% of patients and anterior cerebral artery (ACA) ischemia was noted in 3% of patients. Multiple infarcts were noted in 9.1% of patients. About half of them were smoker, hypertension 42.4%, diabetes mellitus 18.2% and 9.1% had atrial fibrillation.

Conclusion: The stroke is also seen in young people below 45 years. The common risk factors like smoking, Hypertension and Diabetes are increasingly recognized in young patients.