A stroke, a serious medical event occurring when blood flow to a part of the brain is interrupted, can affect a 24-year-old. While often associated with older age groups, strokes can strike individuals in their youth. Recognizing this possibility is crucial for timely response and better outcomes.
The Reality of Stroke in Young Adults
While strokes are more commonly observed in older populations, their occurrence in young adults, typically defined as those under 50 years old, is an increasing concern. Approximately 10% to 14% of all strokes occur in this age group. In the United States, the incidence for adults aged 20–44 years increased from 17 per 100,000 in 1993 to 28 per 100,000 in 2015. This trend indicates that while still less frequent than in older adults, strokes are not exclusively a condition of the elderly.
The rising incidence of stroke among young adults is partly attributed to an increase in traditional risk factors. Despite advancements in cardiovascular disease prevention, the absolute number of incident stroke cases among young adults globally increased by 36% from 1990 to 2021.
Causes and Risk Factors
Stroke in young adults can stem from a variety of causes, some of which are more specific to this age group than to older individuals. The two main types of stroke are ischemic, caused by a blocked blood vessel, and hemorrhagic, caused by a burst blood vessel. Ischemic strokes account for about 60% of strokes in patients under 50, while hemorrhagic strokes comprise about 40% in this age group.
Certain conditions and lifestyle factors contribute to stroke risk in young adults. Patent Foramen Ovale (PFO), a small hole in the heart that doesn’t close after birth, is a factor for some young stroke patients. Arterial dissection, a tear in the wall of an artery (like those in the neck), accounts for a significant portion of strokes in young adults and can occur spontaneously or from physical stress. Genetic disorders such as Fabry disease and Moyamoya disease are also associated with stroke in younger individuals.
Autoimmune conditions like lupus and various blood clotting disorders can increase the risk of both ischemic and hemorrhagic strokes. Lifestyle choices also play a role, with illicit drug use, particularly stimulants, being linked to an increased risk of stroke. Heavy alcohol consumption and tobacco use are also associated with heightened stroke risk.
Traditional risk factors, such as high blood pressure, high cholesterol, obesity, and diabetes, are increasingly prevalent in young adults and contribute to their stroke risk. For women, specific factors like migraine with aura, the use of oral contraceptives containing estrogen, and pregnancy (especially the postpartum period) can further elevate stroke risk. Even a sedentary lifestyle and diets high in processed foods are recognized as contributing factors.
Recognizing the Signs
Recognizing stroke signs promptly is important, as symptoms can appear suddenly. A widely used and easy-to-remember acronym for identifying common stroke signs is FAST:
F – Face drooping: One side of the person’s face may droop or feel numb when they try to smile.
A – Arm weakness: If one arm drifts downward when the person tries to raise both arms, it may indicate a stroke.
S – Speech difficulty: Speech may be slurred, strange, or difficult to understand.
T – Time to call emergency services immediately if any of these signs are observed.
Beyond the FAST signs, other symptoms can also signal a stroke. These include sudden confusion or trouble understanding speech. Vision problems, such as blurred vision or loss of sight in one or both eyes, can occur. Difficulties with walking, sudden dizziness, or a loss of balance and coordination are also indicators. A sudden, severe headache with no known cause is particularly common in hemorrhagic strokes. Even if symptoms seem to improve, medical attention is crucial.
Immediate Action
When stroke symptoms are suspected, immediate action is crucial. The primary step is to call emergency services without delay. This quick response is vital because “time is brain”; approximately 1.9 million neurons are lost each minute during an ischemic stroke without treatment.
Calling emergency services ensures trained professionals can assess the situation, provide immediate care, and transport the individual to a stroke-capable facility. EMS can also pre-notify the hospital, expediting diagnostic tests and treatments. Driving oneself or the affected person to the hospital is not recommended, as this delays life-saving interventions. Even if symptoms subside, medical evaluation is necessary, as a transient ischemic attack (TIA) can be a warning sign of a future, more severe stroke.