STROKE IN YOUNG-ADULTS
STROKE IN YOUNG-ADULTS
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DOI：
10.1161/01.str.21.3.382
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发表时间：
1990-03-01
期刊：
影响因子：
8.3
通讯作者：
BRADLEY, W
中科院分区：
文献类型：
--
作者：
BEVAN, H;SHARMA, K;BRADLEY, W
年轻人中风并不常见，通常是诊断上的挑战。对脑内出血、蛛网膜下腔出血或脑梗死引起的卒中进行了回顾性研究。我们回顾了113名年龄在15-45岁之间的年轻患者的病历，这些患者在1982年至1987年期间被诊断为中风而被佛蒙特州医学中心医院（美国佛蒙特州）收治。这一组包括8.5%的所有年龄段的中风患者，是全国中风调查中观察到的比例的2.3倍。46名年轻患者（41%）被诊断为非创伤性脑出血;主要原因包括动脉瘤、动静脉畸形、高血压和肿瘤。19名年轻患者（17%）发现蛛网膜下腔出血;大多数是由于动脉瘤。其余48名年轻患者（42%）有脑梗死，大多数是由于心源性栓塞和过早动脉粥样硬化。在没有其他危险因素的情况下，二尖瓣脱垂、口服避孕药的使用、饮酒和偏头痛是罕见的脑梗死的唯一原因。这组年轻中风患者的病死率为20.4%，而全国中风调查的病死率为23.9%。年轻的中风患者需要进行广泛的但有针对性的评估，包括血管造影和超声心动图。
Strokes in young adults are uncommon and often a diagnostic challenge. A retrospective study of strokes due to intracerebral hemorrhage, subarachnoid hemorrhage, or cerebral infarction was undertaken. We reviewed the medical records of 113 young patients aged 15-45 years who were admitted to the Medical Center Hospital of Vermont (Vermont, USA) with a diagnosis of stroke between 1982 and 1987. This group comprised 8.5% of patients of all ages admitted for stroke, 2.3 times the proportion observed in the National Survey of Stroke. Nontraumatic intracerebral hemorrhage was diagnosed in 46 young patients (41%); the main causes included aneurysms, arteriovenous malformations, hypertension, and tumors. Subarachnoid hemorrhage was found in 19 young patients (17%); the majority were due to aneurysms. The remaining 48 young patients (42%) had cerebral infarction, the majority due to cardiogenic emboli and premature atherosclerosis. Mitral valve prolapse, the use of oral contraceptives, alcohol drinking, and migraine were infrequent sole causes of cerebral infarction in the absence of other risk factors. The case-fatality rate for this group of young patients with stroke was 20.4% compared with 23.9% for the National Survey of Stroke. Young adults with stroke deserve an extensive but tailored evaluation, which should include angiography and echocardiography.