Kumbha Thulasi Ram1, I. V. Ramachandra Rao2, V. K. Rakesh3
INTRIDUCTION: Stroke is one of the important causes of morbidity and mortality all over the world. Incidence of stroke steadily increases with age. Experts are concerned of the emerging stroke epidemic in India. Stroke affecting the young has potentially devastating consequence son the individual and his family. Certain risk factors are unique to the young. It needs more studies for identification and modification of risk factors. The study aims to evaluate clinical features, risk factors, etiology and mortality of stroke in young patients.
METHODS: 74 young patients satisfying the inclusion criteria were included in this study. A detailed history was taken from young stroke patients, systemic examination and required investigations were done. Data was collected in standardized proforma and analysed.
RESULTS: Stroke in young accounts for 7.95% of stroke cases of all age groups. The mean age of the patients was 34.66 ± 7.48 years. Among 74 patients, 47(63.51%) were male and 27(36.49%) were female. Seizures, decreased consciousness, speech involvement and motor deficit were observed in 33.78%, 44.59%, 22.97% and 100% of cases respectively. 82.43% patients had ischemic and 17.57% patients had hemorrhagic stroke. Among ischemic stroke, large artery atherosclerosis was 16.21%, tuberculous meningoencephalitis with vasculitis was 16.21%, lacunar stroke was 10.81%, CVT was 10.81% and cardio embolic stroke was 6.76%. Smoking (59.45%), alcoholism (58.10%), hypertension (43.24%), coronary artery disease (8.10%), diabetes mellitus (10.81%), elevated total cholesterol (25.67%), elevated low density lipoproteins (22.97%), elevated triglycerides (27.02%) and low HDL (22.97%) were important risk factors. Carotid doppler was abnormal in 9.45% of patients. 6.76% patients had mitral stenosis in echocardiogram. Low protein C and protein S were found in 1.35% of patients. Eight (10.81%) patients died during the hospital stay.
INTERPRETATION AND CONCLUSIONS: The major risk factors for stroke were hypertension, dyslipidemia, smoking, alcoholism and diabetes mellitus. Ischemic stroke was more common than hemorrhagic stroke. CVT was common in postpartum women. 58% of TB meningoencephalitis patients have AIDS. Mortality was higher in hemorrhagic stroke.
