FOCAL CEREBRAL-ISCHEMIA IN YOUNG-ADULTS - A COLLABORATIVE CASE-CONTROL STUDY

Because there is uncertainty about the role of atherogenic and nonathe rogenic risk factors for cerebral ischemia in the young, we carried ou t a multicenter, hospital-based, case-control study. 333 patients (15- 44 years) with focal cerebral ischemia (transient ischemic attack or s troke within 8 weeks of admission) were eligible. 25 patients were exc luded, according to the protocol. 308 cases were matched by age and ge nder to one hospital and one population control. Independent risk was shown by logistic conditional regression for migraine with aura [odds ratio (OR) = 14.8], smoking (OR = 3.7), alcohol (OR = 2.8), serum trig lycerides (OR = 1.6), arrhythmias (OR = 9.5), mitral stenosis (OR = 56 ), coronary heart disease (OR = 4.3) and carotid stenosis or occlusion (OR = 4 1). Serum HDL-cholesterol had a relative protective effect (O R = 0.8). These data confirm the role of atherosclerosis and cardiac d iseases as well as migraine with aura and alcohol consumption in the p athophysiology of cerebral ischemia in the young. More thorough preven tion programs may contribute to earlier detection and control of all o f these risk factors, but further investigations in patients with as y et unidentified risk factors are warranted because the above-mentioned factors do not account for the total risk of ischemic stroke in the y oung.