Abstract Number: Esoc2026a2368 Acute Ischemic Stroke in Young Adults: Clinical Characteristics and Outcomes at a Tertiarystroke Center in the Republic of Moldova

Abstract Background and aims Acute ischemic stroke (AIS) is a leading cause of mortality and long-term disability worldwide. Recent years have shown a decreasing age at stroke onset, with rising incidence among young adults under 50 years. The aim is to analyze clinical characteristics, risk factors, treatment strategies, and short-term outcomes of AIS in young adults treated at a tertiary stroke center in the Republic of Moldova. Methods We conducted a retrospective observational study including young adults hospitalized with AIS at the Diomid Gherman Institute of Neurology and Neurosurgery between 2019 and 2025 out of 400 AIS admissions. Clinical data, risk factors, acute treatments, and functional outcomes were analyzed. Stroke severity was assessed using the NIHSS score at admission and after revascularization, and functional outcome using the modified Rankin Scale (mRS). Results A total of 42 young adults (mean age 36–50 years) were identified, 18 patients during 2019 - 2024, and 24 in 2025. Risk factors included cardiac pathology associated with obesity (73.8%), smoking (66.7%), long-term oral contraceptive use (11.9%), autoimmune disorders (7.1%), and malignancy (7.1%). Large vessel occlusion was present in 90.5% of patients, with a mean admission NIHSS score of 14. Revascularization included intravenous thrombolysis, mechanical thrombectomy, or both. Combined therapy resulted in greater neurological improvement, achieving mTICI 2b/3 in 79.31% of cases. NIHSS improved from 14 to 5, and 76.2% achieved favorable outcome (mRS 2). Conclusions The importance of targeted risk factor assessment, early diagnosis, access to advanced reperfusion therapies in stroke at young patients would lead to a favorable functional outcomes. Conflict of interest Spinei Veronica, nothing to disclose