Risk factors and subtypes of ischemic strokes in young adults: A tertiary care hospital study from southern part of India

Konda M, Varalakshmi EA, Patil A, Kaul S, Yada PK, Jayasree M, Jayalakshmi SS, Surath M

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Muralikrishna Konda¹, Varalakshmi EA¹, Anuja Patil¹, Subhash Kaul^1,*, Praveen Kumar Yada¹, Manukinda Jayasree¹, Sita Jayalakshmi S¹ and Mohandas Surath¹

¹Department of Neurology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

*Corresponding author: Dr. Subhash Kaul, Sr. Consultant Neurologist, Department of Neurology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India. Email: subashkaul@hotmail.com

Received 16 December 2024; Revised 7 March 2025; Accepted 15 March 2025; Published 22 March 2025

Citation: Konda M, Varalakshmi EA, Patil A, Kaul S, Yada PK, Jayasree M, Jayalakshmi SS, Surath M. Risk factors and subtypes of ischemic strokes in young adults: A tertiary care hospital study from southern part of India. J Med Sci Res. 2025; 13(2):101-106. DOI: http://dx.doi.org/10.17727/JMSR.2024/13-18

Copyright: © 2025 Konda M et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: In the last few decades ischemic stroke in young adults (15-45 years) has been increasingly reported. This study was aimed to evaluate the epidemiological features, risk factors and mechanisms of ischemic stroke in young adults.

Methods: From June 2018 to February 2020, patients diagnosed with ischemic stroke in the age group of 15-45 years from a tertiary care referral hospital in Hyderabad, India, were consecutively enrolled to study their risk factors, mechanisms and outcome.

Results: Out of 971 patients of ischemic strokes 164 (16.8%) were young adults, among whom 113 (69%) were in the age group 36-45 years. Males constituted 71.3% of cohort. Risk factors were alcohol abuse (39.63%), dyslipidemia (39.02%), hypertension (32.32%), smoking (27.44%), diabetes (25.61%), family history of stroke (23.78%) and past history of stroke (12.20%). As regards subtypes, large artery atherosclerosis constituted 26.22%, lacunar stroke 15.24%, cardio- embolic strokes 15.85%, stroke of other etiology 18.9% and stroke of unknown etiology 23.78%. At the time of discharge, death and dependency in younger adults was 8.53% and 45.12% respectively.

Conclusion: About 90% of young adults with ischemic stroke had at least 1 established modifiable vascular risk factor. Large artery atherosclerosis both intra and extra-cranial was the most frequent mechanism. Stroke due to other etiologies unique to young adults constituted about one fifth of all ischemic strokes.

Keywords: acute ischemic stroke; stroke in young; cerebrovascular accident; etiologies