Stroke subtypes We investigated the etiologies of ischemic stroke , using the Trial of Org 10172 in Acute Stroke

Background and Objectives: This study aimed to describe the ischemic stroke subtypes and risk factors in young Korean adults, focusing mainly on traditional risk factors and management of ischemic stroke. Methods: The study patients were the fi rst-ever acute cerebral ischemic infarction age 49 years or below admitted to the Kyung Hee University Medical Centre from September 2003 to June 2009, with ischaemic stroke patients >50 years as control. The stroke subtypes was categorized according to Trial of Org 10172 in Acute Stroke Treatment classifi cation. The traditional risk factors of ischemic stroke were examined. For those known to have hypertension and diabetes prior to onset of stroke, their adherence to treatment of hypertension and diabetes was also assessed. Results: Close to half of the patients ≤49 years were due to premature atherosclerosis from small vessel occlusion and large artery atherosclerosis. The most common risk factor in declining order was hypertension, smoking, dyslipidemia and obesity. On logistic regression analysis, hypertension, dyslipidemia, and obesity were strongly associated with small vessel occlusion. In patients who were known to have hypertension and diabetes prior to the onset of stroke, the younger patients were less adherent to the treatment as primary prevention than the older stroke patients. Conclusion: This study suggests that premature atherosclerosis from small vessel occulusion is the most common cause of ischaemic stroke among young adults in Korea. Non-adherence to primary preventive treatment of hypertension and diabetes is common. Neurology Asia 2011; 16(4) : 281 – 289 Address correspondence to: Dae-Il Chang, MD, PhD, Department of Neurology, Kyung Hee University Hospital, #1 Hoegi-dong, Dongdaemun-gu, 130-702, Seoul, Republic of Korea. Tel: 82-2-958-8499, Fax: 82-2-958-8490. Email: dichang@khmc.or. kr INTRODUCTION Ischemic stroke in young adults is uncommon, accounting for 2-12% of all ischemic strokes. Although the treatment and management of stroke has improved in recent years, only a small number of stroke patients can return to work. Sequelae such as hemiplegia or dysphasia in young adult stroke survivors constitute serious problems, both for the survivors, and socio-economically for their community, because young adults are in their most active stage of social life. In young adults, causes of ischemic stroke are more diverse than in the elderly stroke population. Nevertheless, studies have shown hypertension, diabetes, dyslipidemia, heart disease, obesity, and smoking are the major risk factors of ischemic stroke in young adults as well as in older populations. It is important to identify stroke’s etiologies and risk factors in young Korean adults, because racial/ethnic differences have a marked effect on stroke subtypes and risk factors in young adults. This study aimed to describe the subtypes of ischemic stroke in Korean young adults, focusing mainly on the traditional risk factors and the management of ischemic stroke. An understanding of these risk factors and the best management practices may help in developing a better-focused preventative strategies.