Clinical and Etiological Profile of Ischemic Stroke in Young Adults: A Prospective, Observational, Hospital based Study from Seacoast Population of South India

Objectives: To evaluate the clinical and etiological profile and outcome of the acute ischemic stroke in young adults in a tertiary-care hospital of south India.Methods: This study was conducted among 50 acute ischemic stroke patients (clinically and radiologically confirmed) irrespective of sex within the age group of 15-45 years admitted to Department of Neurology after clearance from Institutional Ethical Committee (IEC).A proforma for each of the acute ischemic stroke patients was maintained where all clinical information in brief including particulars of the subject, chief complaints, past history, proper general physical examination and systemic examinations etc were recorded.The patients had been undergone plain CT (computed tomography) scan/MRI (Magnetic Resonance Imaging) brain at admission for radiological confirmation and to localize the site of lesion in brain.All the included patients were followed upto 3 months of discharge to assess the outcome.Results: Hypertension (56%) was the most common risk factor among acute ischemic stroke in young adults.Majority of the acute ischemic stroke patients presented with motor weakness (94% -either in the form of hemiparesis or hemiplegia).Stroke of other determined etiology (62%) with predominant hypercoagulable disorders (Hyperhomocystinemia-55%) was the most common etiology.Beside, imaging findings confirmed right sided brain lesion in majority of the patients (60%) and middle cerebral artery circulation (80%) as the most common territory involved in the brain.Most patients had a good functional outcome after 3 months of discharge with NIHSS score of 0-5 in 90% and mRS score 0-2 in 92% patients. Conclusion:Most common clinical presentation is hemiplegia among the young onset acute ischemic stroke patients.Hypertension is most common risk factor and Stroke of other determined etiology is the most common etiology with middle cerebral arterial circulation being commonly involved and most patients had good functional outcome.Thus, the knowledge of the risk factors, clinical presentation and radiological findings and outcome of acute ischemic stroke in young adults can help in prevention, better understanding of pathogenesis and therapeutic decision making in the disease management.