Stroke in Young People: The Increasing Role of Advanced Imaging

Abstract

Ischemic stroke in young people is an unexpected event due to a wider variety of causes compared to the older population. This study highlights the increasing role of neuroimaging in the diagnosis, prognosis and treatment of young stroke patients. Thirty young adult patients (age range, 15–45 years) with acute ischemic stroke diagnosis were retrospectively included and studied at our institution during 2009. The mean age of patients was 35 years and 50% were men. The stroke etiology was established in 86% of cases (n=26), 7% (n=2) were due to atherosclerosis of the main vessels, 10% (n=3) were related to cardioembolism, 27% (n=8) were due to arterial dissection and 43% (n=13) responded to miscellaneous etiologies. The cause remained unexplained in 14% (n=4) of cases. The aims of neuroimaging in the challenging study of young stroke patients are to confirm the ischemic nature of the lesion, to determine its location, and to verify the patency of major neck and intracranial arteries. Both MRI and MSCT offer the best sensitivity and spatial resolution.