Abstract: Strokes in young adults are reported as being uncommon, comprising 10%–15% of

all stroke patients. However, compared with stroke in older adults, stroke in the young has a dis-

proportionately large economic impact by leaving victims disabled before their most productive

years. Recent publications report an increased incidence of stroke in young adults. This is impor-

tant given the fact that younger stroke patients have a clearly increased risk of death compared

with the general population. The prevalence of standard modifiable vascular risk factors in young

stroke patients is different from that in older patients. Modifiable risk factors for stroke, such as

dyslipidemia, smoking, and hypertension, are highly prevalent in the young stroke population,

with no significant difference in geographic, climatic, nutritional, lifestyle, or genetic diversity.

The list of potential stroke etiologies among young adults is extensive. Strokes of undetermined

and of other determined etiology are the most common types among young patients according

to TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria. Prevention is the primary

treatment strategy aimed at reducing morbidity and mortality related to stroke. Therefore, primary

prevention is very important with regard to stroke in young adults, and aggressive treatment of

risk factors for stroke, such as hypertension, smoking, and dyslipidemia, is essential. The best

form of secondary stroke prevention is directed toward stroke etiology as well as treatment of

additional risk factors. However, there is a lack of specific recommendations and guidelines for

stroke management in young adults. In conclusion, strokes in young adults are a major public

health problem and further research, with standardized methodology, is needed in order to give

us more precise epidemiologic data. Given the increasing incidence of stroke in the young, there

is an objective need for more research in order to reduce this burden.

Keywords: cerebrovascular diseases, age, incidence, risk factors, etiology, management

Despite considerable improvement in primary prevention, diagnostic workup, and treat-

ment, stroke is in second or third place on a mortality list, and projections indicate that

it will remain so in the year 2020. Furthermore, stroke is a leading cause of disability.

Although published reports indicate that stroke is not common in young adults, in

everyday clinical practice we are often faced with acute neurologic symptoms in this

age group, and stroke should be considered as the differential diagnosis. The nature

and etiology of stroke in young adults is different from that in older patients, and

has an influence on diagnostic evaluation and treatment, so knowledge gleaned from

research in older patients cannot always be applied to young adults. Compared with

stroke in older people, stroke in the young has a disproportionately large economic

impact by leaving victims disabled during their most productive years. Of concern are