Recurrence after first cerebral infarction in young adults

Objective - We have investigated recurrence of stroke in a consecutive seri es of young adults, aged 16 to 45 years, after a first cerebral infarction. Methods - From January 1, 1988 to December 31, 1996 we submitted those pat ients to a diagnostic protocol including angiographic, cardiological, and h aematological investigations. The patients were followed at 6 month interva ls up to December 31, 1998, Results We have evaluated and followed-up 135 p atients, 71 men and 64 women, who were 3.99% of all the admitted stroke pat ients. At 12 months after stroke, 83 patients had returned to work, 40 pati ents were mildly to moderately handicapped, 4 were using a wheel-chair, and 8 had died. Follow-up was 26 to 123 months (mean 68.8). Recurrence of stro ke, always of ischaemic nature, was seen in 15 patients (11.1%), 3 to 76 mo nths after the first stroke (mean 27.4), for an annual incidence of 2.26%. Recurrence was significantly associated with Partial Anterior Circulation S yndrome and Haematological subtype of first stroke (respectively, P = 0.020 9 and P = 0.0135, chi(2) test), bur not with age (less than or equal to or >35 years) or risk factors. Repetition of stroke was never fatal, but it ca used heavy disability in 13 patients, 8 of whom had completely or nearly co mpletely recovered after the first event. Conclusions - Our data suggest th at recurrence of stroke is a major clinical problem also for the patients a ged less than 45 years and that it might be more frequent with specific cli nical syndromes and etiologic subtypes of first stroke.