CAUSES OF ISCHEMIC STROKE IN THE YOUNG

The causes of ischaemic stroke in young adults are many and diverse. S uch patients usually require more extensive investigations in order to find an underlying cause than more elderly patients. It is important that a comprehensive search is made since many of the underlying disor ders are treatable. Principal causes are extracranial arterial dissect ion, cardioembolism, premature atherosclerosis, haematological and imm unological disorders and migraine. Drug abuse is becoming increasingly important but the risk of stroke in pregnancy remains unclear. Isolat ed angiitis of the central nervous system, heritable disorders of conn ective tissue and other genetically determined disorders (mitochondria l cytopathies, CADASIL) account for a small proportion of ischaemic st rokes in the young. Management is probably best undertaken by a physic ian with a specialist interest and, if full investigation fails to elu cidate a definite cause, the risk of future stoke is low.