ISCHEMIC STROKE IN THE YOUNG - INFLUENCE OF DIAGNOSTIC-CRITERIA

In 4-66% of young stroke patients in reported series no cause is found . To study the influence of diagnostic criteria on the eventual diagno sis of the ischemic stroke we reviewed retrospectively the results of 71 patients with an ischemic stroke, all aged 20-45 years. In 23 of th e 71 patients a certain cause was found: atherosclerosis (11 patients) , cardiac embolism (6), arterial dissection (3) trauma (2) and vasculi tis (1). Subsequently, we used the diagnostic criteria of other invest igators and applied these to our patient group. The found percentages of explained ischemic stroke varied substantially from 14 to 56%, depe nding on the criteria used. Atherosclerosis ranged from 16 to 27%, car diac causes from 14 to 20%, different vasculopathies from 14 to 17% an d metabolic/hematologic causes from 0 to 22%. The discrepancies about causes of stroke in the young as found in the literature may to a larg e extent be the consequence of varying criteria sets. It is possible t hat more rigorous criteria lead to a larger proportion of unexplained strokes.