Acidente vascular cerebral no adulto jovem.

Resumo

Stroke in young adults is not as uncommon as one might expect and often present a diagnostic challenge. Our purpose was to determinate the incidence and causes of stroke in young adults admitted to our hospital.retrospective study of all patients aged 18-45 years (36,9±7,4 years), admitted to our hospital from January 1998 to December 1999, with the diagnosis of stroke. A data sheet considering clinical profile, past medical history, investigation, stroke classification and cause and early clinical outcome, was filled according to clinical register.During the study period 751 patients were admitted with stroke, 581 (77,3%) with ischemic stroke and 170 (22,7%) with haemorrhage. Forty-five were young adults (6%). Thirty-five had ischemic stroke (77,8%), with a mean age of 37 years; the stroke was in the anterior circulation in 44%. In 94% of the patients risk factors for atherosclerotic vascular disease were identified. Ischemic stroke was classified, according to NINDS, in: atherosclerotic occlusive disease (28,6%), lacuna (14,3%), fibrodysplasia/arterial dissection (11,4%) cardioembolism (11,4%), undetermined (25,7%) and unknown (8,6%), because of early death or abandon. Ten patients were admitted with haemorrhage, with a mean age of 32 years, hypertension was the cause in 50%, altered vascular anatomy (arteriovenous malformation, aneurysm, angioma) in 40% and 10% were of unknown aetiology (early death). Mortality rate in the first week was 11,4% in ischemic stroke and 30% in haemorrhage. From the 45 patients admitted to this study, 85,7% were discharged with autonomy, 28% needed to continue physical rehabilitation.Stroke is an important pathology in the young adults accounting for 6% of all patients admitted with this diagnosis. In our population, atherosclerosis was responsable for an important percentage of cases, probably in association with the high incidence of risk factors for atherosclerotic vascular disease founded. We would like to stress once more the high importance of primary prevention, specially in this young group of patients.