Characteristics of cerebral Infarction in young and old patients
- VernacularTitle:Залуу ба ахимаг насанд тохиолдох тархины шигдээсийн онцлог
- Author:
Delgermaa Ts
;
Tsagaankhuu G
;
Tuvshinjargal D
;
Baigalmaa G
;
Tovuudorj A
- Publication Type:Journal Article
- Keywords:
cerebral Infarction;
young and old patient
- From:Mongolian Medical Sciences
2016;177(3):10-19
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background
Ischemic stroke or cerebral infarction in young adults (20-50 years) is relatively frequent, accounting for
more than 10%-26% of all first strokes and its incidence rises steeply with age. Causes of “Young stroke”
are heterogeneous and while it generally has a good prognosis, it has a significant socioeconomic
impact, including functional deficits and financial costs. The most frequent causes of cerebral infarction
in young adults are cardio-embolism, hypertension, premature atherosclerosis, migraine, smoking and
hypercoagulable states.
Objective
The aim of this study was to compare characteristics of cerebral infarction between young (20-49 years)
and old (50-89 years) patients undergoing investigations and treatment according to one common
protocol in the tertiary hospital.
Methods
This Descriptive case series study was conducted in Department of Neurology of First State Central
Hospital from October 2014 to July 2016. During this study, we observed 220 patients with first-onset
of cerebral infarction from which 90 young patients (under 50 years) and 130 old one (above 50
years), based on prospective study. Data regarding the etiology and risk factors of the stroke, clinical
manifestations, and diagnostic test results of patients were examined during their hospital treatment as
well as a NIHSS, modified Rankin Scale scores, and Barthel Index at admission and discharge, also
at 21 day. Stroke subtyping was conducted in accordance with the Trial of Org 10172 in Acute Stroke
Treatment (TOAST) criteria.
Results
In total, 220 patients with cerebral infarction were included, from which 90 (40.9%) were 20-50 years
and 130 (59.1%) were 50-89 years. The proportion of males was higher among both groups: 61.1% vs.
70.0%. Common causes for cerebral infarction in the young patients were current smoking (53.3.1% vs.
37.8%), long-term alcohol consumption (51.1 vs. 12.3), cardiac embolism (36.0% vs. 16.2%), migraine
with aura (25.5% vs. 12.2%), infective diseases (15.6% vs. 0.8%), and oral contraceptive use (14.4
vs. 0%). Leading causes for ischemic stroke in old patients were the conventional risk factors such as
hypertension (75.4% vs. 38.9%), atherosclerosis (66.9% vs. 31.1), coronary artery disease (24.3% vs.
12%), and diabetes mellitus (26.9% vs. 6.7%). Most of the young stroke patients demonstrated good
functional outcomes, at the time of discharge (71.1% vs. 60%) and three weeks (86.6% vs. 66.2%)
patients had Rankin Scale scores in the range of 0-2.
Conclusions
There are significant differences between young and old patients with cerebral infarction regarding to risk
factors, etiological subtypes and improvement of functional deficits associated with the stroke. However,
severity of stroke on admittance is similar but three weeks outcome is different among young and old
patients with relatively rapid improvement of functional deficit in young stroke patients than old one.
- Full text:P020170420813506182448.pdf
