Our modern life style has put our young adults more at risk
in health issues than their elders.
Stroke in young adults is
one of the health issues about which we need to create awareness among the
general public. This will alert both the young adults as well as their parents/guardians
to take preventive measures. Stroke is a public health issue that causes
long-term disabilities with emotional and socio economic consequences.
First of all, what
stroke is all about?
Stroke is associated with a new onset of rapidly developing
symptoms and signs of loss of cerebral function lasting more than 24 hours with
no apparent cause other than that of vascular origin. Stroke is of two kinds,
one hemorrhagic and second ischemic.In one type, rupturing of blood vessels of
the skull occurs. In the other type, bleeding occurs at the spot between the
arachnoid membrane and pia mater around the brain. These two are the major causes of stroke in young adults.
Major causes of stroke in young adults and children are
different from that of older people.
Strokes develop within 24 hours of onset of symptoms, all
occurring within 10 days. Therefore, early suspicion and diagnosis is necessary
to prevent stroke. Migraine is an underlying factor for stroke and it also is
an acute precipitant of stroke (migrainous stroke). Ischemic stroke risk is
higher in females having migraine and using oral contraceptives which are a
known independent risk factor for ischemic and hemorrhagic strokes. People aged
over 35 with a history of hypertension with smoking habits are prone to get
stroke attacks.
F.A.S.T.
Regardless of age, symptoms for stroke are indicated in the
acronym F.A.S.T. “F” for drooping face
on the one side, “A” for arms that cannot be raised, “S” for slurred speech,
and “T” for time indicating timely action. The acronym FAST is to help detect
stroke symptoms and immediate hospitalization.
General symptoms which are not exhaustive
·
Sudden numbness or weakness of the face, arms,
or legs particularly on one side of the body.
·
Sudden confusion, trouble speaking or
understanding difficulty.
·
Sudden vision difficulties in one or both the
eyes.
·
Sudden severe headache.
General risk factors,also
called as modifiable risk factors in young adults
·
Smoking
·
Alcoholism
·
Diabetes
·
Hypertension
·
Dyslipidemia
·
Past history of stroke
·
Rheumatic heart disease with atrial fibrillation
·
Oral contraceptive pills in women
·
Nonatheroscleroticangiopathies
·
Cervicocephalic
arterial dissection
·
Cerebral amyloid angiopathy
·
Moyamoya disease
·
Fibromusculardysplacia
·
Reversible cerebral vasoconstriction syndrome
·
Susac’s syndrome
·
Sneddon’s syndrome
·
Migraine-induced stroke
Hematologic conditions
·
Hypercoagulable state due to deficiencies of protein
S, protein C or antithrombin;
·
Factor V Leiden mutation etc
Genetic
·
Fabry disease
·
CADASIL (cerebral autosomal dominant arteriopathy with
subcortical infarcts and leukoencephalopathy)
·
MELAS
·
Marfan syndrome
·
Neurofibromatosis
·
Sturge-Weber disease
Inflammatory and
infectious
·
Vasculitis
·
Temporal arteritis
·
Takayasu disease
·
Bechet’s syndrome
·
Neurosarcoidosis
·
Neurocysticerosis
·
HIV
·
Varicella zoster virus
·
Neurosyphilis
·
Tuberculous meningitis
According to a study, about 5.8 million people had been
affected by stroke as far back as in 2005. Stroke has emerged as the second
most common cause of death. Globally 7.8 million deaths have been estimated to
occur due to stroke by 2030. By 2050,
India will be one of the regions where 80 % of stroke events will occur.
Prevention of Stroke
Quit smoking and have regular physical exercise for 20
minutes a day at least three to four days in a week. Ensure against high blood pressure, high
cholesterol levels and blood sugar levels.
Primary stroke prevention in young adults includes aggressive treatment
of hypertension, smoking, and dyslipidemia. Secondary stroke prevention
involves stroke etiology and treatment of additional risk factors. Secondary
stroke prevention aims at prevention and reducing risk of a second stroke after
identification etiology of initial stroke as part of stroke rehabilitation.
Although stroke in young adults occurs
only in 10-15 % of all stroke patients, this section of the population suffers
severe economic consequences as young adults are disabled well before their
most productive years. Apart from aggressive treatment and control of risk
factors, life style changes can prevent up to 50 % of strokes.
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