Young adults with ischemic stroke in the Republic of Moldova`s tertiary neurology center

Abstract

Introduction. Ischemic stroke in young adults is a rising health problem with multiple risk factors and a big socio-economic impact. Aim of the study. The aim of the study was to characterize the cohort of Moldovan young ischemic stroke patients. Materials and methods. Was done a retrospective medical records evaluation of 1687 patients with ischemic stroke treated in tertiary neurology center from January 2018 till December 2019. Were identified 59 patients aged 50 and less and included in the study. To all the study patients was analyzed the risk factors profile, clinical presentation, neuroimaging, and comorbidities. Results. The study cohort consists of 67.9% men and 32.1% women, mean age – 42.95±6.7. In 82.1% was the first-ever stroke and 17.9% - recurrent. The middle cerebral artery territory was affected by 76.8%, mostly in the left hemisphere – 46.4% and posterior territory – 19.6% with brainstem location in 12.5%. The first clinical presentation was motor deficit – 60.7%, speech impairment – 23.2%. NIHSS was 10.03±5.14. Neuroimaging shows: ischemic lesion – 94.6%, concomitant lacunar infarcts/leukoaraiosis – 28.6%, old strokes – 19.6%. Large vessel occlusion was documented in 12.5% (left side – 75%), stenosis – 30.4% (mean 43.5±15.7%) and vertebral artery hypoplasia – 25%. In 55.4% of patients, the sedimentation rate was elevated and in 26.8% - leukocytosis. Only 41.1% of patients were on anterior treatment and 7.1% had anticoagulant drugs. In 26.8% patient different types of infection were documented prior to stroke onset. Conclusions. Moldovan cohort of young adults with ischemic stroke presents the same risk factor profile as older adults with the trigger role of infections in the stroke onset.