@article{3159343,
    title = "Etiology of first-ever ischaemic stroke in European young adults: the 15
cities young stroke study",
    author = "Barlas, N. Yesilot and Putaala, J. and Waje-Andreassen, U. and and Vassilopoulou, S. and Nardi, K. and Odier, C. and Hofgart, G. and and Engelter, S. and Burow, A. and Mihalka, L. and Kloss, M. and Ferrari, J. and and Lemmens, R. and Coban, O. and Haapaniemi, E. and Maaijwee, N. and and Rutten-Jacobs, L. and Bersano, A. and Cereda, C. and Baron, P. and and Borellini, L. and Valcarenghi, C. and Thomassen, L. and Grau, A. J. and and Palm, F. and Urbanek, C. and Tuncay, R. and Durukan Tolvanen, A. and van and Dijk, E. J. and de Leeuw, F. -E. and Thijs, V. and Greisenegger, S. and and Vemmos, K. and Lichy, C. and Bereczki, D. and Csiba, L. and Michel, P. and and Leys, D. and Spengos, K. and Naess, H. and Tatlisumak, T. and Bahar, and S. Z.",
    journal = "European Journal of Paediatric Neurology",
    year = "2013",
    volume = "20",
    number = "11",
    pages = "1431-1439",
    publisher = "Wiley",
    issn = "1090-3798",
    doi = "10.1111/ene.12228",
    keywords = "cerebral infarct; etiology; ischaemic stroke (IS); stroke in young
adults",
    abstract = "Background and purposeRisk factors for IS in young adults differ between
genders and evolve with age, but data on the age- and gender-specific
differences by stroke etiology are scare. These features were compared
based on individual patient data from 15 European stroke centers.
MethodsStroke etiology was reported in detail for 3331 patients aged
15-49years with first-ever IS according to Trial of Org in Acute Stroke
Treatment (TOAST) criteria: large-artery atherosclerosis (LAA),
cardioembolism (CE), small-vessel occlusion (SVO), other determined
etiology, or undetermined etiology. CE was categorized into low- and
high-risk sources. Other determined group was divided into dissection
and other non-dissection causes. Comparisons were done using logistic
regression, adjusting for age, gender, and center heterogeneity.
ResultsEtiology remained undetermined in 39.6%. Other determined
etiology was found in 21.6%, CE in 17.3%, SVO in 12.2%, and LAA in
9.3%. Other determined etiology was more common in females and younger
patients, with cervical artery dissection being the single most common
etiology (12.8%). CE was more common in younger patients. Within CE,
the most frequent high-risk sources were atrial fibrillation/flutter
(15.1%) and cardiomyopathy (11.5%). LAA, high-risk sources of CE, and
SVO were more common in males. LAA and SVO showed an increasing
frequency with age. No significant etiologic distribution differences
were found amongst southern, central, or northern Europe.
ConclusionsThe etiology of IS in young adults has clear gender-specific
patterns that change with age. A notable portion of these patients
remains without an evident stroke mechanism according to TOAST criteria.
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}