Abstract Details

Title Acute Ischemic Stroke in Young Adults

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P17 - Poster Session 17 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-004

Objective Acute ischemic stroke (AIS) in young adults represents a unique population that requires special considerations in terms of diagnosis and evaluation.

Background We performed retrospective review of AIS hospitalizations at our academic comprehensive stroke center (CSC) from January 2014 to January 2019.

Design/Methods AIS in young adult was defined as age <= 30 years. Data was collected on demographics, last known normal time , National Institutes of Health Stroke scale , and AIS reperfusion therapy. Stroke subtype was categorized per Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification as Small vessel disease , Large artery atherosclerosis , Cardioembolic , Cryptogenic, and Other

Results

Among 44 patients, the mean age was 26.2 years , 14(31.8%) were female, 29(65.9%) were white, and 8 (18%) were Black. 34(77.3%) were transferred from outside hospital Emergency Rooms . The median NIHSS was 5(range 0 to 24). 24(54.5%) presented outside the intravenous tissue plasminogen activator window. Among 20 patients who presented in the IVtPA window, 5(25%) received IVtPA with a mean LKN to IVtPA administration of 141.8 minutes . Three patients were released from ER and re-presented with worsening deficits. IVtPA was not given for those in the window due to absolute contraindication , mild deficits , and unclear . Five underwent thrombectomy (1 concomitant IVtPA). TOAST subtype included 3(6.8%) SVD, 1 (2.3%) LAA, 4 (9.1%) CE, 17 (38.6%) cryptogenic, and 19 (43.2%) Other. The Other subtype diagnosis included Moyamoya 7(15.9%), Dissection 4 (9.1%), Endocarditis 2(4.5%), hypercoaguable state 2(4.5%), cerebral venous thrombosis 2(4.5%), Neuro-syphilis 1, and Liebman Sacks 1(2.3%).

Conclusions In our series of AIS in young adults (age < = 30) hospitalized at an academic tertiary referral CSC, the most common TOAST subtype was Other (43.2%) and Cryptogenic(38.6%). Only 1 in 4 AIS in young adult received thrombolysis. Recognition of stroke diagnosis in young adults remains challenging and final TOAST subtype for young adults includes diverse rare etiologies

Authors/Disclosures
Narsis Aminian, MD PRESENTER	Dr. Aminian has nothing to disclose.
	No disclosure on file
Vivien H. Lee, MD, FAAN (OSU Comprehensive Neurovascular Center)	Dr. Lee has nothing to disclose.

��ɫ��

��ɫ��