Skip to main content
Top
Published in: Neurological Sciences 2/2021

01-02-2021 | Migraine | Original Article

Ischemic stroke in young adults in Bogota, Colombia: a cross-sectional study

Authors: Maria Paula Aguilera-Pena, Andres Felipe Cardenas-Cruz, Ivan Baracaldo, Elkin Garcia-Cifuentes, Maria Isabel Ocampo-Navia, Elza Juliana Coral

Published in: Neurological Sciences | Issue 2/2021

Login to get access

Abstract

Background

There has been an increase in the incidence of ischemic stroke in young adults. It is believed that it is due to the increase in traditional cardiovascular risk factors. This change has affected the quality of life of young adults.

Aims

To describe the most common etiologies and risk factors in patients aged ≤ 50 who had ischemic stroke between 2011 and 2018.

Methodology

A cross-sectional study of patients under 50 years who had ischemic stroke between 2011 and 2018 who were evaluated at a comprehensive center in Bogotá, Colombia. We carried out a descriptive analysis of comorbidities, the Trial of Org for Acute Stroke (TOAST), the National Institute of Health Stroke Scale (NIHSS), and the modified Rankin Scale (mRS).

Results

A total of 152 patients were included, out of which 50.66% were men. The most frequent traditional risk factors were smoking history (19%), history of high blood pressure (18%), presence of cardiovascular disease (17%), and history of migraine (15%). The most common etiological subgroups were those classified as “other determined etiologies” (33.5%) and “undetermined etiology” (33.5%), while the most common etiology was carotid or vertebral artery dissection (23%).

Conclusion

This study demonstrates the need to make a deep evaluation of the past medical history, laboratory tests, and new risk factors in young adults. On the other hand, modifiable cardiovascular risk factors top the list, showing the need to implement health promotion strategies for young adults.
Appendix
Available only for authorised users
Literature
1.
go back to reference Ekker MS, Boot EM, Singhal AB, Tan KS, Debette S, Tuladhar AM, de Leeuw FE (2018) Epidemiology, aetiology, and management of ischaemic stroke in young adults. Lancet Neurol 17:790–801CrossRef Ekker MS, Boot EM, Singhal AB, Tan KS, Debette S, Tuladhar AM, de Leeuw FE (2018) Epidemiology, aetiology, and management of ischaemic stroke in young adults. Lancet Neurol 17:790–801CrossRef
2.
go back to reference Uggetti C (2003) Stroke in young people: imaging. Neurol Sci 24(S1):s15–s16CrossRef Uggetti C (2003) Stroke in young people: imaging. Neurol Sci 24(S1):s15–s16CrossRef
3.
go back to reference Kristensen B, Malm J, Carlberg B, Stegmayr B, Backman C, Fagerlund M, Olsson T (1997) Epidemiology and etiology of ischemic stroke in young adults aged 18 to 44 years in Northern Sweden. Stroke 28:1702–1709CrossRef Kristensen B, Malm J, Carlberg B, Stegmayr B, Backman C, Fagerlund M, Olsson T (1997) Epidemiology and etiology of ischemic stroke in young adults aged 18 to 44 years in Northern Sweden. Stroke 28:1702–1709CrossRef
4.
go back to reference Kittner SJ, McCarter RJ, Sherwin RW et al (1993) Black-White differences in stroke risk among young adults. Stroke 24:15 Kittner SJ, McCarter RJ, Sherwin RW et al (1993) Black-White differences in stroke risk among young adults. Stroke 24:15
5.
go back to reference Putaala J, Metso AJ, Metso TM, Konkola N, Kraemer Y, Haapaniemi E, Kaste M, Tatlisumak T (2009) Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry. Stroke 40:1195–1203CrossRef Putaala J, Metso AJ, Metso TM, Konkola N, Kraemer Y, Haapaniemi E, Kaste M, Tatlisumak T (2009) Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry. Stroke 40:1195–1203CrossRef
6.
go back to reference Fonarow GC, Reeves MJ, Zhao X, Olson DM, Smith EE, Saver JL, Schwamm LH, Get With the Guidelines-Stroke Steering Committee and Investigators (2010) Age-related differences in characteristics, performance measures, treatment trends, and outcomes in patients with ischemic stroke. Circulation 121:879–891CrossRef Fonarow GC, Reeves MJ, Zhao X, Olson DM, Smith EE, Saver JL, Schwamm LH, Get With the Guidelines-Stroke Steering Committee and Investigators (2010) Age-related differences in characteristics, performance measures, treatment trends, and outcomes in patients with ischemic stroke. Circulation 121:879–891CrossRef
7.
go back to reference Kappelle LJ, Adams HP, Heffner ML, Torner JC, Gomez F, Biller J (1994) Prognosis of young adults with ischemic stroke. A long-term follow-up study assessing recurrent vascular events and functional outcome in the Iowa Registry of Stroke in Young Adults. Stroke 25(7):1360–1365 Kappelle LJ, Adams HP, Heffner ML, Torner JC, Gomez F, Biller J (1994) Prognosis of young adults with ischemic stroke. A long-term follow-up study assessing recurrent vascular events and functional outcome in the Iowa Registry of Stroke in Young Adults. Stroke 25(7):1360–1365
8.
go back to reference Putaala J, Curtze S, Hiltunen S, Tolppanen H, Kaste M, Tatlisumak T (2009) Causes of death and predictors of 5-year mortality in young adults after first-ever ischemic stroke: The Helsinki Young Stroke Registry. Stroke 40(8):2698–2703CrossRef Putaala J, Curtze S, Hiltunen S, Tolppanen H, Kaste M, Tatlisumak T (2009) Causes of death and predictors of 5-year mortality in young adults after first-ever ischemic stroke: The Helsinki Young Stroke Registry. Stroke 40(8):2698–2703CrossRef
9.
go back to reference Varona JF, Bermejo F, Guerra JM, Molina JA (2004) Long-term prognosis of ischemic stroke in young adults. Study of 272 cases. J Neurol 251:1507–1514CrossRef Varona JF, Bermejo F, Guerra JM, Molina JA (2004) Long-term prognosis of ischemic stroke in young adults. Study of 272 cases. J Neurol 251:1507–1514CrossRef
10.
go back to reference Waje-Andreassen U, Thomassen L, Jusufovic M, Power KN, Eide GE, Vedeler CA, Naess H (2013) Ischaemic stroke at a young age is a serious event--final results of a population-based long-term follow-up in Western Norway. Eur J Neurol 20:818–823CrossRef Waje-Andreassen U, Thomassen L, Jusufovic M, Power KN, Eide GE, Vedeler CA, Naess H (2013) Ischaemic stroke at a young age is a serious event--final results of a population-based long-term follow-up in Western Norway. Eur J Neurol 20:818–823CrossRef
11.
go back to reference Aarnio K, Rodríguez-Pardo J, Siegerink B, Hardt J, Broman J, Tulkki L et al (2018) Return to work after ischemic stroke in young adults: a registry-based follow-up study. Neurology 91(20):e1909–e1917CrossRef Aarnio K, Rodríguez-Pardo J, Siegerink B, Hardt J, Broman J, Tulkki L et al (2018) Return to work after ischemic stroke in young adults: a registry-based follow-up study. Neurology 91(20):e1909–e1917CrossRef
12.
go back to reference Maaijwee NAMM, Rutten-Jacobs LC, Schaapsmeerders P et al (2014) Ischaemic stroke in young adults: risk factors and long-term consequences. Nat Rev Neurol 10:315–325CrossRef Maaijwee NAMM, Rutten-Jacobs LC, Schaapsmeerders P et al (2014) Ischaemic stroke in young adults: risk factors and long-term consequences. Nat Rev Neurol 10:315–325CrossRef
13.
go back to reference Boot E, Ekker MS, Putaala J, Kittner S, De Leeuw F, Tuladhar AM (2020) Ischaemic stroke in young adults: a global perspective. J Neurol Neurosurg Psychiatry 91(4):411–417CrossRef Boot E, Ekker MS, Putaala J, Kittner S, De Leeuw F, Tuladhar AM (2020) Ischaemic stroke in young adults: a global perspective. J Neurol Neurosurg Psychiatry 91(4):411–417CrossRef
14.
go back to reference Ji R, Schwamm LH, Pervez MA, Singhal AB (2013) Ischemic stroke and transient ischemic attack in young adults: risk factors, diagnostic yield, neuroimaging, and thrombolysis. JAMA Neurol 70:51–57CrossRef Ji R, Schwamm LH, Pervez MA, Singhal AB (2013) Ischemic stroke and transient ischemic attack in young adults: risk factors, diagnostic yield, neuroimaging, and thrombolysis. JAMA Neurol 70:51–57CrossRef
15.
go back to reference Saavedra M, Asociada P, Trujillo FG et al (2001) Factores de riesgo en enfermedad cerebro vascular isquémica en pacientes menores de 45 años. Rev la Fac Med 49(2):89–99 Saavedra M, Asociada P, Trujillo FG et al (2001) Factores de riesgo en enfermedad cerebro vascular isquémica en pacientes menores de 45 años. Rev la Fac Med 49(2):89–99
16.
go back to reference Adams H Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 24(1):35. (d)CrossRef Adams H Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL et al (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 24(1):35. (d)CrossRef
17.
go back to reference Lyden P, Brott T, Tilley B, Welch KM, Mascha EJ, Levine S et al (1994) Improved reliability of the NIH Stroke Scale using video training. NINDS TPA Stroke Study Group. Stroke 25(11):2220CrossRef Lyden P, Brott T, Tilley B, Welch KM, Mascha EJ, Levine S et al (1994) Improved reliability of the NIH Stroke Scale using video training. NINDS TPA Stroke Study Group. Stroke 25(11):2220CrossRef
18.
go back to reference Oliveira Filho MD, T Mullen MD. Initial assessment and management of acute stroke. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc https://www.uptodate.com (Accessed on June 02, 2019) Oliveira Filho MD, T Mullen MD. Initial assessment and management of acute stroke. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc https://​www.​uptodate.​com (Accessed on June 02, 2019)
19.
20.
go back to reference Harmsen P, Berglund G, Larsson O, Tibblin G, Wilhelmsen L (1979) Stroke Registration in Göteborg, Sweden, 1970–75. Acta Med Scand 206:337–344CrossRef Harmsen P, Berglund G, Larsson O, Tibblin G, Wilhelmsen L (1979) Stroke Registration in Göteborg, Sweden, 1970–75. Acta Med Scand 206:337–344CrossRef
21.
go back to reference Rasura M, Spalloni A, Ferrari M, Castro S, Patella R, Lisi F, Beccia M (2006) A case series of young stroke in Rome. Eur J Neurol 13:146–152CrossRef Rasura M, Spalloni A, Ferrari M, Castro S, Patella R, Lisi F, Beccia M (2006) A case series of young stroke in Rome. Eur J Neurol 13:146–152CrossRef
22.
23.
go back to reference Patella R, Spalloni A, Ferrari M, La Starza S, Bozzao A, Rasura M (2011) Cerebral ischemia in young patients (under 45 years of age): clinical and neuroradiological follow-up. Neurol Sci 32(3):427–432CrossRef Patella R, Spalloni A, Ferrari M, La Starza S, Bozzao A, Rasura M (2011) Cerebral ischemia in young patients (under 45 years of age): clinical and neuroradiological follow-up. Neurol Sci 32(3):427–432CrossRef
24.
go back to reference Nedeltchev K, der Maur TA, Georgiadis D, Arnold M, Caso V, Mattle HP, Schroth G, Remonda L, Sturzenegger M, Fischer U, Baumgartner RW (2005) Ischaemic stroke in young adults: predictors of outcome and recurrence. J Neurol Neurosurg Psychiatry 76:191–195CrossRef Nedeltchev K, der Maur TA, Georgiadis D, Arnold M, Caso V, Mattle HP, Schroth G, Remonda L, Sturzenegger M, Fischer U, Baumgartner RW (2005) Ischaemic stroke in young adults: predictors of outcome and recurrence. J Neurol Neurosurg Psychiatry 76:191–195CrossRef
25.
go back to reference Lee T-H, Hsu W-C, Chen C-J, Chen ST (2002) Etiologic study of young ischemic stroke in Taiwan. Stroke 33:1950–1955CrossRef Lee T-H, Hsu W-C, Chen C-J, Chen ST (2002) Etiologic study of young ischemic stroke in Taiwan. Stroke 33:1950–1955CrossRef
26.
go back to reference Jaffre A, Ruidavets JB, Nasr N, Guidolin B, Ferrieres J, Larrue V (2015) Tobacco use and cryptogenic stroke in young adults. J Stroke Cerebrovasc Dis 24:2694–2700CrossRef Jaffre A, Ruidavets JB, Nasr N, Guidolin B, Ferrieres J, Larrue V (2015) Tobacco use and cryptogenic stroke in young adults. J Stroke Cerebrovasc Dis 24:2694–2700CrossRef
27.
go back to reference Bhat VM, Cole JW, Sorkin JD, Wozniak MA, Malarcher AM, Giles WH, Stern BJ, Kittner SJ (2008) Dose-response relationship between cigarette smoking and risk of ischemic stroke in young women. Stroke 39:2439–2443CrossRef Bhat VM, Cole JW, Sorkin JD, Wozniak MA, Malarcher AM, Giles WH, Stern BJ, Kittner SJ (2008) Dose-response relationship between cigarette smoking and risk of ischemic stroke in young women. Stroke 39:2439–2443CrossRef
28.
go back to reference Saposnik G, Del Brutto OH (2003) Stroke in South America: a systematic review of incidence, prevalence, and stroke subtypes. Stroke 34:2103–2107CrossRef Saposnik G, Del Brutto OH (2003) Stroke in South America: a systematic review of incidence, prevalence, and stroke subtypes. Stroke 34:2103–2107CrossRef
29.
go back to reference Koellhoffer EC, McCullough LD (2013) The effects of estrogen in ischemic stroke. Transl Stroke Res 4:390–401CrossRef Koellhoffer EC, McCullough LD (2013) The effects of estrogen in ischemic stroke. Transl Stroke Res 4:390–401CrossRef
30.
go back to reference Cífková R, Krajčoviechová A (2015) Dyslipidemia and cardiovascular disease in women. Curr Cardiol Rep 17:1–10CrossRef Cífková R, Krajčoviechová A (2015) Dyslipidemia and cardiovascular disease in women. Curr Cardiol Rep 17:1–10CrossRef
31.
go back to reference Camerlingo M, Romorini A, Ferrante C, Valente L, Moschini L (2010 Jun) Migraine and cerebral infarction in young people. Neurol Sci 31(3):293–297CrossRef Camerlingo M, Romorini A, Ferrante C, Valente L, Moschini L (2010 Jun) Migraine and cerebral infarction in young people. Neurol Sci 31(3):293–297CrossRef
32.
go back to reference Scher AI, Launer LJ (2010) Migraine with aura increases the risk of stroke. Nat Rev Neurol 6:128–129CrossRef Scher AI, Launer LJ (2010) Migraine with aura increases the risk of stroke. Nat Rev Neurol 6:128–129CrossRef
33.
go back to reference Laurell K, Artto V, Bendtsen L, Hagen K, Kallela M, Meyer EL, Putaala J, Tronvik E, Zwart JA, Linde M (2011 Oct) Migrainous infarction: a Nordic multicenter study. Eur J Neurol 18(10):1220–1226CrossRef Laurell K, Artto V, Bendtsen L, Hagen K, Kallela M, Meyer EL, Putaala J, Tronvik E, Zwart JA, Linde M (2011 Oct) Migrainous infarction: a Nordic multicenter study. Eur J Neurol 18(10):1220–1226CrossRef
34.
go back to reference Altamura C, Cascio Rizzo A, Maggio P, Viticchi G, Paolucci M, Brunelli N et al (2019) Prevalence and clinical profile of migraine with aura in a cohort of young patients with stroke: a preliminary retrospective analysis. Neurol Sci 40(S1):185–186CrossRef Altamura C, Cascio Rizzo A, Maggio P, Viticchi G, Paolucci M, Brunelli N et al (2019) Prevalence and clinical profile of migraine with aura in a cohort of young patients with stroke: a preliminary retrospective analysis. Neurol Sci 40(S1):185–186CrossRef
35.
go back to reference Amarenco P, Bogousslavsky J, Caplan LR, Donnan GA, Wolf ME, Hennerici MG (2013) The ASCOD phenotyping of ischemic stroke (Updated ASCO Phenotyping). Cerebrovasc Dis 36:1–5CrossRef Amarenco P, Bogousslavsky J, Caplan LR, Donnan GA, Wolf ME, Hennerici MG (2013) The ASCOD phenotyping of ischemic stroke (Updated ASCO Phenotyping). Cerebrovasc Dis 36:1–5CrossRef
36.
go back to reference Leys D, Bandu L, Hénon H et al (2002) Clinical outcome in 287 consecutive young adults (15 to 45 years) with ischemic stroke. Neurology 59:26–33CrossRef Leys D, Bandu L, Hénon H et al (2002) Clinical outcome in 287 consecutive young adults (15 to 45 years) with ischemic stroke. Neurology 59:26–33CrossRef
Metadata
Title
Ischemic stroke in young adults in Bogota, Colombia: a cross-sectional study
Authors
Maria Paula Aguilera-Pena
Andres Felipe Cardenas-Cruz
Ivan Baracaldo
Elkin Garcia-Cifuentes
Maria Isabel Ocampo-Navia
Elza Juliana Coral
Publication date
01-02-2021
Publisher
Springer International Publishing
Keywords
Migraine
Stroke
Published in
Neurological Sciences / Issue 2/2021
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-020-04584-2

Other articles of this Issue 2/2021

Neurological Sciences 2/2021 Go to the issue