Analysis of 50 cases of Stroke in Young Adults

Senthilrani, N (2009) Analysis of 50 cases of Stroke in Young Adults. Masters thesis, Coimbatore Medical College, Coimbatore.

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Abstract

In this study, 50 young adults with stroke were included. The incidence in men was 64% compared to 36% in women. This is in agreement with studies conducted by other centers. In this study, the peak incidence of stroke was observed in the age group of 36-40 years which was 32%. It was 20% in the age group of 31-35 years. In a study conducted by P.M.Dalal et al, the incidence of stroke was maximum in the age group of 36-40 years which is similar to our study. In our study 52% of patients were above the age of 30 years, compared is 48% patients in the above study. Analysis of Risk factors :- Hypertension : Hypertension is one of the common risk factors associated with stroke. The incidence of hypertension was 18% in this study. In a study conducted by P.G.A.Sander Cock et al81 this incidence was 32%. Diabetes Mellitus : Out of 50 patients studied, 2 patients had diabetes mellitus. Hyperlipidemia : 7 Patients who had abnormal lipid profile were affected by premature atherosclerosis. Transient Ischaemic attack : Incidence of TIA was 10% in this study. In the study conducted by L.N.Jones the incidence of TIA was 14%. Smoking : In this study, out of 22 male patients, 20 were smokers. The remaining 18 patients were female non smokers. It became an important risk factor mainly due to premature atherosclerosis associated with it. Cordiac Source of Emboli : Cordiac source of emboli was observed in 26% of cases. In the study conducted by P.M.Dalal et al, the incidence of cordiac source of emboli was 20%. In our study, 10% of patients had atrial fibrillation. In the oxford shire community stroke project81, the incidence of atrial fibrillation was 17%. 7 Patients had RHD, out of which 5 were in AF. 2 Patients had congenital heart disease (TOF). Alcohol : In this study, 32% of males were alcoholics, out of them one person had stroke followed by an alcoholic binge. Similar observation of stroke in young men after alcoholic binge, was noted by M.R.Wilkins, M.J.Kendall82. 8% of patients who presented with haemorrhagic stroke had arterio venous malformation in the cerebral vascular system. 4% of young patients with stroke had Takayasu’s arteritis involving carotid & Subclavian artery. Cervical arterial Bruit : Cervical arterial bruit was observed in 2% of cases. In the Dalal et al. study, it was observed in 9% of cases. Uncertain Causes : Stroke due to undetermined causes was 6% in our study & in oxford shire community study, it was 5%. A definite risk factor was present in 70% of cases in our study but according to other observation it was 80%. More than one risk factors were noted in 30% of cases. Serum Homocystein level was raised in 6 patients who had cerebral infarct. (Normal Range 3.7 – 13.9 mmol/L). In our study, out of 50 patients, one had Antithrombin – III deficiency. One patient developed metastatic brain abcess originated from congenital heart disease (TOF) Types of Stroke : In this study ; • Ischaemic stroke was present in 66% of cases. • Haemorrhagic stroke was present in 26% of cases but according to Harvard cooperative stroke registry study, the incidence was 15%. • Cortical vein thrombosis was seen in 12% of cases & all the patients observed were female in post partum period. Similar observation was made by M.E. Yeolker. According to Dalal et al study80, which included 93 cases for a period of 5 years, the incidence of Ischaemic stroke was 80.60% and Haemorrhagic stroke was 12.50% when compared with this study, the incidence of Ischaemic stroke was 66% and haemorrhagic stroke was 26% in our study. CONCLUSION : 1. The incidence of stroke in young adults is more common in the age group between 36-40 years & males are more affected (64%) than females (36%). 2. Cardioembolic stroke is the commonest cause of stroke in young adults. Smoking is the most significant risk factor for stroke in young adults mainly due to the premature atherosclerosis associated with it. 3. Even though mitral value prolapse is consided as one of the major risk factors for stroke in young adults, in our study, out of 50 young patients who had stroke only 2 had MVP. But even in those cases MVP was not the cause for stroke. 4. TIA is experienced by 10% of patients. 5. All the patients who suffered from cortical vein thrombosis are females in puerperal period. 6. Among hypercoagulopathies causing stroke, hyperhomocysteinemia is the commonest followed by antithrombin III deficiency. 7. In about 6% of cases, no cause could be attributed. 8. The predominant mode of presentation of stroke is middle cerebral territory involvement. The commonest pathological type is (ischaemic stroke (66%)). 9. In vascular disease, takayasu’s arteritis causes 4% of stroke & arteriovenous malformation causes 8% of stroke.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Stroke ; Young Adults ; Analysis ; 50 cases.
Subjects: MEDICAL > General Medicine
Depositing User: Subramani R
Date Deposited: 17 Feb 2018 18:32
Last Modified: 17 Feb 2018 18:32
URI: http://repository-tnmgrmu.ac.in/id/eprint/5834

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