Evaluation and Management of Stroke in Young Adults

Jason Mackey, MD, MS Cerebrovascular Disease p. 352-369 April 2014, Vol.20, No.2 doi: 10.1212/01.CON.0000446106.74796.e9
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Purpose of Review:: This article provides an overview of the evaluation and management of ischemic stroke in young adults, with an emphasis on cervical artery dissection, patent foramen ovale, and hypercoagulable states.

Recent Findings:: The incidence of ischemic stroke in young patients is increasing, although the reasons remain unclear. Patients with ischemic stroke at a young age are more likely to die at an early age than their peers. Well-established vascular risk factors are prevalent in young stroke patients. Recent studies have informed the treatment of dissection and patent foramen ovale among others. The utility of testing for hypercoagulable states in ischemic stroke is unclear.

Summary:: Ischemic stroke in young adults is a major public health problem. A wide range of etiologies of ischemic stroke is found in this age group. A careful history, thorough examination, and methodical workup are essential. Specific management is predicated on identification of the underlying etiology.

Address correspondence to Dr Jason Mackey, 355 West 16th Street, Suite 3200, Indianapolis, IN 46202, jasonmackey78@gmail.com.

Relationship Disclosure: Dr Mackey has served as an expert medical record reviewer in vascular neurology for court cases and has received funding as the principal investigator for outcomes and processes of care in intracerebral hemorrhage for the Indiana University Health Values Fund and the Indiana Clinical and Translational Sciences Institute Project Development Team. He is also a recipient of a NIH Loan Repayment Program award.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Mackey reports no disclosure.

© 2014 American Academy of Neurology