Imaging Spectrum of Stroke in Young Adults: A Retrospective Study
DOI:
https://doi.org/10.48047/e89acm20Keywords:
Young adult stroke, Ischaemic stroke, Intracerebral haemorrhage, Cerebral venous sinus thrombosis, NeuroimagingAbstract
Background: Stroke in young adults differs from stroke in older populations in terms of underlying causes, clinical characteristics, and neuroimaging findings. Young stroke is associated with substantial long-term disability and socioeconomic burden, making accurate diagnosis and aetiological evaluation essential. Neuroimaging plays a pivotal role in identifying stroke subtype, vascular involvement, and underlying mechanisms.
Objectives: To describe the imaging spectrum of stroke in young adults and to evaluate the distribution of stroke subtypes, underlying aetiologies, vascular territories, and characteristic neuroimaging features.
Methods: This retrospective observational study was conducted in the Department of Radiodiagnosis and included 130 young adults aged 18–45 years with a confirmed diagnosis of acute stroke. Neuroimaging studies, including computed tomography (CT), magnetic resonance imaging (MRI), CT angiography, MR angiography, and venographic examinations, were reviewed. Stroke subtype, vascular territory, presumed aetiology, and characteristic imaging findings were recorded and analysed descriptively.
Results: The mean age of participants was 36 ± 7 years, and 58% were male. Ischaemic stroke was the predominant subtype, occurring in 88 patients (68%), followed by haemorrhagic stroke in 31 patients (24%) and cerebral venous sinus thrombosis (CVST) in 11 patients (8%). Among ischaemic strokes, arterial dissection, cardioembolic disorders, and vasculitic or other uncommon causes were prominent, with a notable proportion remaining cryptogenic. Characteristic imaging findings included diffusion-restricted infarcts and arterial occlusions in ischaemic stroke, parenchymal haematomas with associated vascular abnormalities in haemorrhagic stroke, and venous sinus filling defects with venous infarction in CVST.
Conclusion: Stroke in young adults exhibits a distinctive and heterogeneous imaging profile, characterised by a predominance of ischaemic stroke and a relatively high frequency of dissection, cardioembolic causes, and CVST. Comprehensive neuroimaging, including arterial and venous vascular assessment, is essential for accurate diagnosis, aetiological classification, and optimisation of secondary prevention strategies.
Downloads
References
Smajlović D. Strokes in young adults: epidemiology and prevention. Vasc Health Risk Manag. 2015;11:157–164.
Ekker MS, Boot EM, Singhal AB, et al. Epidemiology, aetiology, and management of ischaemic stroke in young adults. Lancet Neurol. 2018;17(9):790–801.
Maaijwee NA, Rutten-Jacobs LC, Schaapsmeerders P, et al. Ischaemic stroke in young adults: risk factors and long-term consequences. Nat Rev Neurol. 2014;10(6):315–325.
Putaala J, Metso AJ, Metso TM, et al. Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki Young Stroke Registry. Stroke. 2009;40(4):1195–1203.
Bersano A, Borellini L, Motto C, et al. Cryptogenic stroke and patent foramen ovale in young patients. Cerebrovasc Dis. 2015;39(2):117–125.
Yesilot Barlas N, Putaala J, Waje-Andreassen U, et al. Etiology of first-ever ischaemic stroke in European young adults: the 15 cities young stroke study. Eur J Neurol. 2013;20(11):1431–1439.
Allen LM, Hasso AN, Handwerker J, Farid H. Sequence-specific MR imaging findings that are useful in dating ischemic stroke. Radiographics. 2012;32(5):1285–1297.
Adams HP, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke: definitions for use in a multicenter clinical trial (TOAST). Stroke. 1993;24(1):35–41.
Saver JL. Cryptogenic stroke. N Engl J Med. 2016;374(21):2065–2074.
Schievink WI. Spontaneous dissection of the carotid and vertebral arteries. N Engl J Med. 2001;344(12):898–906.
Saposnik G, Barinagarrementeria F, Brown RD, et al. Diagnosis and management of cerebral venous thrombosis: AHA/ASA statement. Stroke. 2011;42(4):1158–1192.
Leys D, Bandu L, Henon H, et al. Clinical outcome in 287 consecutive young adults (15 to 45 years) with ischemic stroke. Neurology. 2002;59(1):26–33.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation .
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
