Research Article
Volume 12 Issue 8 - 2020
Risk Factors and Etiologies of Stroke in Young Adults: 6 Years Retrospective Study
Amal M Al-Hashmi*, Said Al-Mawali, Sachin Jose and Reem Al Habsi
Stroke Unit / Royal Hospital / Ministry of Health, Muscat, Oman
*Corresponding Author: Amal M Al-Hashmi, Stroke Unit / Royal Hospital / Ministry of Health, Muscat, Oman.
Received: June 09, 2020; Published: July 15, 2020


Background: Although a large number of studies have been published on the incidence of stroke in young adults, very few have looked at etiologies in the youth of the Middle East, and none have focused on Oman.

Method: Retrospective study carried out at the Royal Hospital in Muscat. Electronic Charts were reviewed identifying all patients under 50 years of age admitted for acute stroke from 2009 to 2014. We analyzed the detailed history, past medical history, risk factors, neurologic and systemic examination, and brain imaging (CT or MRI) for each case. We identified 588 young patients163 were excluded due to other diagnosis or absence of neuroimaging (CT or MRI).

Results: Out of the 425 stroke cases. Overall, 60% of the cases were 41-50 years of age. Ischemic Stroke (IS) occurred in 69.6% compared to 30.4% for Intracranial hemorrhage (ICH). Hypertension(H) was the number one risk factor for both IS and ICH, with a prevalance 50.7% and 60.5% respectively. DM was the second leading risk factor, with a prevalence of 32.1% in IS and 27.1% in ICH. Underlying etiologies were identified in only 35.5% of cases in IS and 29.5% in ICH. Cardiac etiology and vasculopathy were most common for IS. Aneurysm was the main underlying etiology for HS.

Conclusion: In young adult Omanis, IS was more frequent than ICH. Men were more affected than women. H and DM were the leading risk factors for both stroke subtypes. Cardioembolism and vasculopathy were the main etiologies for IS. Cerebral anuerysm for HS.

Keywords: Stroke; IS: Ischemic Stroke; ICH: Intracranial Hemorrhage; HS: Hemorrhagic Stroke: Hypertension; Cardioembolic; Vasculopathy; Dyslipidemia


  1. Bevan H., et al. “Stroke in young adults”. Stroke3 (1990): 382-386.
  2. Griffiths D and Sturm J. “Epidemiology and Etiology of Young Stroke”. Stroke Research and Treatment (2011): 1-9.
  3. Walker AE., et al. “The National Survey of Stroke. Clinical findings”. Stroke2-2 (1981): 13-44.
  4. Smajlović D. “Strokes in young adults: epidemiology and prevention”. Vascular Health and Risk Management 11 (2015): 157-164.
  5. Nencini P., et al. “Incidence of stroke in young adults in Florence, Italy”. Stroke 8 (1988): 977-981.
  6. Obeid T., et al. “Stroke in the young in Riyadh area Saudi Arabia” 1 (1991): 89.
  7. Putaala J., et al. “Demographic and geographic vascular risk factor differences in European young adults with ischemic stroke: the 15 cities young stroke study”. Stroke10 (2012): 2624-2630.
  8. Kristensen B., et al. “Epidemiology and etiology of ischemic stroke in young adults aged 18 to 44 years in northern Sweden”. Stroke9 (1997): 1702-1709.
  9. Putaala J., et al. “Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry”. Stroke4 (2009): 1195-1203.
  10. Lee T-H., et al. “Etiologic study of young ischemic stroke in Taiwan”. Stroke 8 (2002): 1950-1955.
  11. Koivunen R-J., et al. “Incidence, risk factors, etiology, severity, and short-term outcome of non-traumatic intracerebral hemorrhage in young adults”. European Journal of Neurology 1 (2015): 123-132.
  12. Awada A. “Stroke in Saudi Arabian young adults: a study of 120 cases”. Acta Neurologica Scandinavica 5 (1994): 323-328.
  13. Khan FY. “Risk factors of young ischemic stroke in Qatar”. Clinical Neurology and Neurosurgery 9 (2007): 770-773.
  14. El Zunni S., et al. “Stroke: Incidence and pattern in Benghazi, Libya”. Annals of Saudi Medicine 4 (1995): 367-369.
  15. Abdul-Ghaffar NU., et al. “Stroke in Kuwait: a three-year prospective study”. Neuroepidemiology1 (1997): 40-47.
  16. Nayak SD., et al. “Ischaemic stroke in the young adult: clinical features, risk factors and outcome”. The National Medical Journal of India 3 (1997): 107-112.
  17. Radhakrishnan K., et al. “Stroke in the young: incidence and pattern in Benghazi, Libya”. Acta Neurologica Scandinavica 4 (1986): 434-438.
  18. Flint AC., et al. “Detection of paroxysmal atrial fibrillation by 30-day event monitoring in cryptogenic ischemic stroke: The Stroke and Monitoring for PAF in Real Time (SMART) Registry”. Stroke10 (2012): 2788-2790.
  19. Elijovich L., et al. “Intermittent atrial fibrillation may account for a large proportion of otherwise cryptogenic stroke: a study of 30-day cardiac event monitors”. Journal of Stroke and Cerebrovascular Diseases Off Journal of Stroke and Cerebrovascular Diseases 3 (2009): 185-189.
  20. Montalvo M., et al. “Long-term Arrhythmia Monitoring in Cryptogenic Stroke: Who, How, and for How Long?” The Open Cardiovascular Medicine Journal 10 (2016): 89-93.
  21. Sinha A-M., et al. “Cryptogenic Stroke and underlying Atrial Fibrillation (CRYSTAL AF): design and rationale”. American Heart Journal 1 (2010): 36-41.
  22. Man Mohan Mehndiratta and Prachi Mehndiratta. “Stroke in the Young: Newer Concepts in Etiopathogenesis and Risk Factors”. Astrocyte 5 (2018): 26-32.
Citation: Amal M Al-Hashmi., et al. “Risk Factors and Etiologies of Stroke in Young Adults: 6 Years Retrospective Study”. EC Neurology 12.8 (2020): 77-85.

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