Young Strokes: What we know for sure

?      A stroke occurring in young people is called a young stroke. ?Young? is defined as either under 45 years of age or under 50 years of age in the scientific literature. Cam had his stroke when he was still 49 years old.

?      Broadly speaking, there are two types of stroke: haemorrhagic strokes (bleeds) and ischaemic strokes (clots). Cam’s stroke was an ischaemic stroke.

?      The incidence of young stroke is about 10% of all strokes.

?      Mortality over a 20 year period is higher in young people with strokes than in older people with strokes.

?      The mortality rate after 10 years is seven times higher in young stroke patients than in the general population.

?      A recurrent stroke in young stroke patients increases the risk of death to 17 times greater than those with one stroke.

?      Despite previous thinking that young strokes are more likely to be caused by rare factors such as arterial dissection, cardiomyopathy and hypercoagulable factors, it is now thought that the cause of young stroke are pretty much the same as in older people: over age 40, elevated blood pressure, type 1 diabetes, a history of transient ischaemic attack, dyslipidemia, cardiovascular risk factors and smoking.

The only risk factor Cam had before his strokes was that he was aged over 40, however, in the weeks preceding his stroke his blood pressure skyrocketed due to stress.

?      Anecdotal evidence says that young people who have strokes have a greater physical resilience and better ability to recover function than older people who have strokes. However, young adult stroke patients experience higher death rates, higher risk of cardiovascular events, and significant limitations in quality of life.

?      After 10 years, nearly 13% of young stroke patients are unable to function independently.

?      Compared with older adults, stroke in young adults has a disproportionately large economic impact because they are left disabled before their most productive years.

?      Control of risk factors and lifestyle changes can prevent 50% of strokes.

?      Hypertension is the most significant risk factor and is present in more than 50% of all strokes. Cam’s blood pressure had been fine till approximately one month prior to his stroke. It has since been dangerously high on many occasions and is difficult to manage with medication.

?      Adrenalin (caused by stress) inhibits potassium. Chronically low potassium resulting from chronically high adrenaline can cause cardiac arrhythmias which can throw off clots leading to strokes. In hospital Cam was found to have dangerously low potassium and a concomitant cardiac arrhythmia.

?      Young patients who have had one stroke should control their blood pressure tightly at 130/80 mmHg to reduce the risk of secondary stroke.

?      The cumulative recurrence rate of stroke in young adults is 9.4%.

So what does all this mean? It means that Cam now has to take all measures to save his life and to save his quality of his life by preventing recurrent strokes. To this end, he must remove himself from all stressors. Any court cases that Cam is engaged in will be conducted by his lawyer(s) and those with Power(s) of Attorney with Cam’s involvement being at arm’s length only. Any in-person Court appearances will be closely medically monitored. We will not allow the stress of Court proceedings to kill him.

Cam is similarly unable to return work and unable to involve himself in other projects that he previously enjoyed. Thanks to the loyal, hardworking and capable team that he has, Cam’s business operations will continue at full tilt, but without his involvement.

References:

  • Nedeltchev, K., der Maur, T.A., Georgiadis, D., et al (2005). Ischaemic stroke in young adults: predictors of outcome and recurrence. Journal of Neurosurgical Psychiatry, 76, 191?195.
  • Putaala, J., Metso, A.J., Metso, T.M., et al (2009). Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki Young Stroke Registry. Stroke, 40, 1195?1203.
  • Smajlovi? D. (2015). Strokes in young adults: epidemiology and prevention. Vascular health and risk management, 11, 157-64. doi:10.2147/VHRM.S53203
  • Smajlovi?, D.?., Salihovi?, D., Ibrahimagi?, O.?., Sinanovi?, O. (2013). Characteristics of stroke in young adults in Tuzla Canton, Bosnia and Herzegovina. College of Anthropology, 37, 515?519.
  • Varona, J.F., Guerra, J.M., Bermejo, F., Molina, J.A., de la Camara, G. (2007). Causes of ischemic stroke in young adults, and evolution of the etiological diagnosis over the long term. European Neurology, 57, 212?218.
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