Summary
In a group of 75 patients under the age of 45 years with stroke, ischaemic cerebral infarction was diagnosed in 60 patients and primary intracerebral haemorrhage in 15. Trauma was found to be the commonest identifiable predisposing factor to cerebral infarction, being present in 13 cases (22%). Migraine was the second most commonly identified predisposing factor while atheroma and hypertension were infrequent. Such a high frequency of preceding trauma has not previously been described, perhaps because it is not generally appreciated that the delay between the traumatic event and subsequent stroke may be considerable. The diagnostic management of young stroke patients is considered with particular reference to the indications for specialized cardiac and neuroradiological investigations.
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References
Abraham J, Shetty G, Jose CJ (1971) Strokes in the young. Stroke 2:258–267
Ad Hoc Committee on Classification of Headache (1962) JAMA 179:717–718
Barnett HJM, Baughner DR, Taylor DW, Cooper PE, Kostuk WJ, Nichol PM (1980) Further evidence relating mitral valve prolapse to cerebral ischaemic events. NEJM 302:139–144
Bickerstaff ER (1975) Neurological complications of oral contraceptives. Oxford, Oxford University Press
Dorfman LJ, Marshall WH, Enzmann DR (1979) Cerebral infarction and migraine: clinical and radiologic correlations. Neurology (Minneap) 29:317–322
Editorial (1983) Lancet II:660–661
Fisher CM (1980) Late-life migraine accompaniments as a cause of unexplained transient ischaemic attacks. Can J Neurol Sci 7:9–17
Grindal AB, Cohen RJ, Saul RF, Taylor JR (1978) Cerebral infarction in young adults. Stroke 9:39–42
Hart RG, Miller VT (1983) Cerebral infarction in young adults: a practical approach. Stroke 14:110–114
Hatano S (1976) Experience from a multicentre stroke register: a preliminary report. Bull WHO 54:541–553
Hindfelt B, Nilsson O (1977) Brain infarction in young adults. Acta Neurol Scand 55:145–157
Humphrey JG, Newton TH (1980) Internal carotid artery occlusion in young adults. Brain 83:565–578
Hungerford GD, du Boulay GH, Zilkha KJ (1976) Computerised axial tomography in patients with severe migraine: a preliminary report. J Neurol Neurosurg Psychiatry 39:990–994
Kendall BE, Radue EW (1978) Computed tomography in spontaneous intracerebral haematoma. Br J Radiol 51:563–573
Milligan N, Anderson M (1980) Conjugal disharmony: a hitherto unrecognised cause of strokes. Br Med J 2:421–422
Mitchinson MJ (1980) The hypotensive stroke. Lancet I:244–246
Preston FE, Martin JF, Stewart RM, Davies-Jones GAB (1979) Thrombocytosis, circulating platelet aggregates, and neurological dysfunction. Br Med J 2:1561–1563
Ross Russell RW (1983) Less common varieties of cerebral arterial disease. In: Ross Russell RW (ed) Vascular disease of the central nervous system. Churchill Livingstone, Edinburgh, pp 368–404
Royal College of General Practitioners Oral Contraception Study (1983) Incidence of arterial disease among oral contraceptive users. J R Coll Gen Pract 33:75–82
Schultz U, Kutemeyer M, Kern A, Hepp W (1984) Traumatic occlusion of both internal carotid arteries. J Neurol 231:233–236
Sedzimir CB (1955) Head injury as a cause of internal carotid thrombosis. J Neurol Neurosurg Psychiatry 18:293–296
Vollman J, Nadjafi AS, Stalker CG (1976) Surgical treatment of kinked internal carotid arteries. Br J Surg 63:847–850
Warlow CP (1979) The young stroke. Br J Hosp Med 22:252–259
Warlow CP (1984) Carotid endarterectomy: Does it work? Stroke 15:1068–1076