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Publications

Journal Article Multicenter Study Ppublish

PubMed: 41701754 DOI: 10.1093/esj/aakag003

Arterial ischaemic stroke in adolescents and very young adults-results of a European cohort.

Eur Stroke J 11(2)

Authors: Eva Luisa Jung, Manoëlle Kossorotoff, Merel Sanne Ekker, Anna-Lisa Oechsle, Kim Tran Dong, Martin Olivieri, Victoria Lieftüchter, Florian Heinen, Christian Denier, Frank-Erik de Leeuw, Lucia Gerstl

Affiliations

  • Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Dr. v. Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany. Department of Neuropediatrics and Muscle Disorders, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.
  • French Center for Pediatric Stroke, Pediatric Neurology Department, APHP University Hospital Necker-Enfants malades, Paris, France.
  • Inserm U1266, Paris, France - Institut de Psychiatrie et Neurosciences de Paris (IPNP), Paris, France.
  • Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
  • Richterswill, Switzerland.
  • Pediatric Thrombosis and Haemostasis Unit, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.
  • Pediatric Intensive Care Medicine, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.
  • Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Munich University Center for Children with Medical and Developmental Complexity - iSPZ Hauner MUC, Dr. v. Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.
  • Stroke Units and Department of Neurology of Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Paris Saclay University, Le Kremlin-Bicêtre, France.

Abstract

INTRODUCTION

Arterial ischaemic stroke (AIS) in adolescents and young adults differs from older populations due to its variety of risk factors and aetiologies. This study compares the risk factor profiles and age- and sex-related differences between adolescents and very young adults.

PATIENTS AND METHODS

Pooled data from three multicentre cohort studies in Europe (Germany, France, The Netherlands) were analysed. First-ever symptomatic AIS cases in adolescents (10-18 years) and very young adults (18-30 years) were classified using both a paediatric AIS classification (multiple risk factor category system) and the modified Trial of ORG 10172 in Acute Stroke Treatment criteria for adults.

RESULTS

The cohort includes 142 adolescents (median age 15) and 131 very young adults (median age 25). Using the adult AIS classification, cryptogenic stroke was most common (43% in adolescents, 32% in young adults). Thirty-two percent had other determined aetiologies. The paediatric classification showed similar results regarding identified causes; 29% resulted in cryptogenic stroke, respectively. Sex distribution differed by age: male predominance in adolescents (61%) and female predominance in young adults (57%).

DISCUSSION

Adolescence and young adulthood may represent a shared age group with similar causes and risk profiles for AIS. The high rate of cryptogenic stroke suggests potential limitations in current classification systems for AIS aetiology at these ages.

CONCLUSION

This cohort highlights the need for an age-adapted risk factor system that accounts for the transitional nature and the complexity of stroke in this age group.

MeSH

Ischemic Stroke, Stroke, Classification, Adolescent, Risk Factors