Etiologies and risk factors of cerebral infarctions in Mongolian young adults
- VernacularTitle:Монгол залуу хүмүүст тохиолдох тархины шигдээсийн шалтгаан, эрсдэлт хүчин зүйл
- Author:
Delgermaa Ts
;
Tovuudorj A
;
Tsagaankhuu G
- Publication Type:Journal Article
- Keywords:
Ischemic stroke;
TOAST classification;
Young adult
- From:Mongolian Medical Sciences
2015;172(2):47-54
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background
Stroke in young person is less frequent than in older populations but has a major impact on the
productive individuals and society.
Objective
To determining risk factors and etiological subtypes of cerebral infarctions in patients of young (20-49
years) age who were admitted to the First Central hospital in Ulaanbaatar, Mongolia.
Methods
This paper is based on a review of hospital-based studies of patients with cerebral infarction in
age range 20-49 years which was conducted from 2009 to 2013. Data regarding onset of cerebral
infarction, clinical
manifestations, diagnostic test results of patients were examined during their
hospital treatment and modified Rankin Scale scores at discharge. Subtyping of cerebral infarction
was conducted in accordance with the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria.
Results
Out of total number of 1289 patients admitted for cerebral infarctions, 259 (20.1%) were in the 20-49
year age range and the male-to-female ratio was 1.3:1. The most common conventional risk factors
were hypertension (39.8%), premature atherosclerosis (20.8%) and dyslipidemia (17.8%). From
the rare specific risk factors in young patients with cerebral infarction were migraine with aura in
combination with other risk factors and hypotension, and cerebral vasculopathies. The majority of
subtype of cerebral infarction was undetermined (34.7%), followed by other determined etiologies
(19.7%). Among the category of undetermined etiology, incomplete evaluation (71.1%) was
predominant. Most of the patients demonstrated good functional outcomes, at the time of hospital
discharge, 86.9% patients had Rankin Scale scores in the range of 0-2 points.
Conclusions
Young adults with cerebral infarction account for 20.1% of all stroke patients in tertiary referral hospital
in Ulaanbaatar. Risk factors, including conventional and specific causes in combination relatively
prevalent in young adults, and a high rate of the patients are categorized under conventional, other
determined and undetermined
etiologies. Cerebral infarction in the young requires a different approach
to investigation and management than ischemic stroke in the elderly given differences in the relative
frequencies of possible underlying causes. The results show the needs for persistent management of
conventional risk factors and properly patient investigation to determine etiology of cerebral infarction
in young patients in Mongolia.
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