Objective: Stroke in young adults can be devastating. Studies on young ischemic stroke have been published in many countries for a variety of ethnic subgroups. Studies representing Australia, however, are lacking.
Methods: We evaluated 326 first-ever ischemic strokes aged 15 to 50 years admitted to any public hospital in Adelaide from January 2006 to June 2010. Stroke risk factors, etiologies by TOAST classification, and neuroimaging findings were evaluated by age, gender, and ethnicity. We then compared our findings with those of other countries.
Results: The most frequent stroke risk factors were dyslipidemia (57%), smoking (49%), hypertension (32%) and obesity (28%). Illicit drug use (16%) consisted largely of marijuana and amphetamines. The prevalence of traditional risk factors increased with age. Alcohol excess was more common in males, and females suffered more migraines. Cardiovascular disease and diabetes were more common in Australian Aboriginals compared to Caucasians. The most frequent stroke etiologies were cardioembolism (26%), dissection (15%), and small vessel disease (10%). Cardioembolism was highly prevalent compared to other countries. More strokes occurred in the anterior (57%) compared to the posterior (28%) circulation, with more strokes concurrently involving both vascular territories (9%) compared to other countries.
Conclusions: In comparison with most countries, young ischemic stroke in South Australia is characterized by more obesity, marijuana, and amphetamine abuse, more cardioembolism, and more strokes concurrently involving both anterior and posterior circulations.