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What causes a stroke in young people. What happens after an attack. Types of strokes and characteristics

The age of boys and girls from 20 to 30 years old is considered the strongest in comparison with people who have managed to live in their fourth or fifth decade. Previously, there was no need to think about stroke among the young population. Now things are completely different, a stroke at a young age, starting from the age of 20, has become a common problem.

Situations in which people of young age do not pay attention to pronounced symptoms of dizziness, headache, accompanied by nausea and a sharp jump in blood pressure. They think that nothing serious is happening to them and soon they will feel normal. With this attitude, young boys and girls are bedridden.


Medicine still does not find a single solution to why this happens to those people who have just moved on to the path of adulthood.

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Stroke is divided into the following types:

  • Ischemic stroke. The most common variety, it affects only minor areas of the lobes of the cerebral hemispheres. It occurs due to blockage of blood vessels, due to the formation of blood clots, embolism, cholesterol plaques.


The same risk group includes people with cancer, as well as those who did not think to be examined in time immediately after suffering a brain injury or other problems associated with inflammatory processes in the body.

  • Hemorrhagic stroke is more acute than the first. Pathology in this case arises spontaneously, due to aneurysm of the cerebral vessels, when the blood does not slow down as in ischemia, but pours out into the external cerebral cavity.

The nature of the consequences for each type of stroke is different, it happens not only in young and elderly people, even in newborns, the stroke is in the same severe form. He doesn't pick people by age.

causes


Stroke among young women and men occurs due to inattention to health.

There are also situations when young people, during festivities at discos or celebrating a wedding ceremony, celebrate the fun by consuming a large number of strong alcoholic beverages, drugs and smoking cigarettes. Then there comes a moment when some of the guests feel bad, which is most often associated with intoxication. Indeed, in such a situation, a person is unable to maintain body coordination. In some cases, convulsions, numbness, high blood pressure, dizziness and nausea.


For what reasons, doctors state a stroke among young people:

  • If young people often have high blood pressure.
  • Disruption of the heart muscle.
  • Injuries associated with pathologies in the carotid artery.
  • Blood clotting disorder.
  • Frequent unreasonable headaches.
  • Infectious complications. Cause changes on the surface of the arterial walls and lead to further destruction.
  • In women at the age of 20, the use of hormonal drugs, contraceptives can provoke the manifestation of a stroke. The result is blood thinning or excessive blood clots.
  • If a stroke occurs in the family of young people.
  • Sometimes a stroke occurs between 20 and 30 years of age. This is caused by excessive consumption of low alcohol products, sedentary lifestyle, drug use and smoking cigarettes. Young guys and girls who drink alcohol and smoke up to 20 years old sin with such bad habits.


  • Blockage of blood vessels due to the formation of fatty plaques occurs not only in people who have lived up to retirement age. Young men and women under 30 are also at risk of stroke due to their high BMI.

Doctors are not always able to immediately determine the signs of a stroke, but only additional studies of the brain, the delivery of urine and blood for biochemistry. Outwardly, the symptoms are similar to the poisoning of the body with potent drugs, alcoholic liquid, or drug overdose.

Peculiarities


If in childhood, a stroke is more common in male infants, then in adolescence with a probability of 70% it manifests itself in women under 30 years of age. Many girls, having felt the signs of a stroke for the first time, ignore the symptoms to a greater extent, which eventually ends in early death or disability.

How do doctors feel like they can define a stroke among the female population:

  • Numbness of the facial muscles for a short period of time.
  • The left or right eye stops seeing clearly. Blinding is observed in both eyes at once.
  • Sharp headache.
  • Convulsive pains in the limbs.
  • Occurrence of hiccups for no reason.
  • Nausea is a common symptom of a stroke.
  • Feeling of pain in the abdomen.
  • Confusion of consciousness for several minutes.
  • Changes in heart rate accompanied by a sudden tingling sensation on the left side.
  • Sleep problems.


The risk of stroke in women increases if girls start smoking, and this also applies to men. It is this reason that remains unattended, which subsequently leads to such disastrous results as a stroke. While smoking cigarettes, the brain does not receive the required amount of oxygen, cells gradually die, blood circulation is impaired.

How to reduce your risk


If the damage has affected a small part of the brain, then recovery will take place within a few months. If, after the examination, the patient found wider and more extensive areas of hematoma formation, then there is a possibility that the person will not survive without help. In such a situation, many patients cannot talk, move their arms and legs, which will take at least one year to recover.


Only taking care of your body will prevent the onset of a stroke, it is important to know the following:

  • You can provoke a stroke if you do not monitor the balance of your diet, eat food with dyes and flavorings. Including smoked sausages, fish, meat. Also, if you lean heavily on pastries with sweet creams, rolls and white bread.
  • A stroke can affect women from 20 to 30 years old who are afraid of becoming pregnant and take hormonal contraceptives. The risk of stroke increases if during the course the girl still smokes, drinks and does not monitor her health. This ends with the fact that the composition of the blood changes, the level of blood clots increases.
  • Cerebral hemorrhage occurs when taking low-alcohol products in both men and women from 20 to 30 years old.
  • Food should contain a minimum of fat.
  • A long-term headache occurs, which usually appears in the evenings or after experiencing severe stress, lack of sleep.


  • High blood pressure only applies to an older society. But lately, medical statistics have shown a lot of facts among young women and men from 20 to 30 years old.
  • For headaches of unknown nature, as well as after head injuries, have a tomography scan every 6 months.
  • The use of potent medicines in high doses and without the recommendation of doctors.

If you do not seek medical help in time and ignore any moments of poor health, then subsequently a person's life will change dramatically. A stroke can happen to anyone, starting from 20- years of age or much earlier, if this was observed among the relatives of young people.

Stroke occurs due to impaired blood circulation in the brain. It has become a very common disease in our time and has become much younger. Now this is no longer the prerogative of people who have reached old age. Let's take a look at the main causes of cerebral stroke in young and old age.

I would like to note that the main reason for this pathology is also located in our head, or rather in our thoughts. In a stupid attitude that you can violate the laws of nature. Yes, of course, they can be ignored, which is what we are doing. So the disease is the consequences of our unreasonable actions, irresponsible attitude to the body, both in the young and in the elderly. Unfortunately, not many people are health conscious.

Prerequisites

The prerequisites for the onset of brain disease are metabolic disorders, unhealthy diet and a sedentary lifestyle. Moreover, all this follows from one another and is very interconnected.

Stroke can proceed according to two main scenarios - ischemic and hemorrhagic. Each has certain factors or causes that cause it, which disrupt the blood circulation in the brain due to internal processes or external mechanical damage.

Ischemic cerebral stroke

In another way, such a stroke is called a cerebral infarction. Disease of elderly people. It occurs most often and accounts for 80% of all strokes. There is a disruption in the work of cerebral vessels (vessels of the brain). The brain does not receive oxygen and other nutrients in the required amount. They are transported by blood through the arteries. This leads to the death of nerve cells.

Causes of cerebral infarction

First of all, this is the narrowing of the cerebral vessels. It occurs due to the deposition of cholesterol plaques on the vascular walls, gradually the artery can completely close. Thrombosis or blockage of blood vessels by blood clots, which develop in places where cholesterol plaques are deposited, is also possible. Embolism is the process of blockage of small vessels of the brain by dense particles wandering through the blood. This can be a detached blood clot, food debris, the consequences of surgery, blood clots, pieces of a tumor. Spasm of cerebral vessels, which may be the result of nervous strain, headaches, internal pathological processes.

Hemorrhagic stroke

In another way, it is called a cerebral hemorrhage. At high pressure or for any other reason, a rupture can occur in the cerebral vessel. The blood that comes out of the vessel forms a hematoma or swelling. The neoplasms press on the brain tissue, pushing their walls apart. The process can take place both in the brain itself - intracerebral hemorrhage, and between the brain and its membrane - subarachnoid hemorrhage. It is hemorrhagic stroke that people are prone to at a young age. This disease can occur from 30 to 60 years old.

If you manage to eliminate the immediate cause of the disease quickly, then the risk of stroke is significantly reduced. And the threat of adverse consequences (paralysis, paresis, disorder of the vestibular apparatus) recedes. It is even better not to bring the matter to such pathological contamination of the bloodstream. If the body is clean, then no terrible disease will happen.

Risk factors

Risk factors that predispose to the development of this pathology: old age; males are more prone to disease; bad habits - alcohol, smoking, drugs; the use of hormonal agents; chemical pollution of the body - drugs, toxic substances in the environment; congenital vascular disorder of the brain; hereditary factor; lack of bioflavonoids in the diet.

Cardiovascular disease and ischemic stroke in young people

The high blood pressure has become quite rejuvenated. Now it is not only grandfathers and grandmothers who suffer with it. Hypertension is characterized by severe headaches that lead to pathological changes in the functioning of cerebral vessels. Spasms and blockages appear. The risk of having a stroke increases.

The immediate cause of a stroke in a young person can be cardiovascular diseases such as:

hypertension, endocarditis, arrhythmia, heart disease, myocardial infarction.

Causes of ischemic stroke in the elderly

Stroke in the elderly can be the result of atherosclerotic vascular damage, which is quite common. Also hypertension or other disorders. For example, diabetes in the elderly causes devastating changes in the walls of blood vessels that can lead to stroke. Other vascular diseases that contribute to ischemic stroke of the brain: vasculitis, vasopathy.

Ischemic stroke can cause other pathologies of the body:

  • Increased blood clotting.
  • Diseases that are associated with the blood system.
  • Diseases that are inherited.
  • Brain infarction associated with migraine.
  • Oncology.

This set of reasons stems from one channel, the name of which is the dirty internal environment of the body. What does a person do if a sewer is clogged in his house? He just cleans it. Your painful condition tells you about the malfunctioning of the body systems. Cleanse the body, vascular system. Everything will be restored. Life will be happy again.

Some of the immediate causes of cerebral hemorrhage are:

  • Infectious or toxic damage to the vessel.
  • Congenital anomalies.
  • Hereditary diseases.
  • Atherosclerosis.

A hemorrhagic stroke of the brain in a young person may appear as a result of an injury, severe physical or emotional stress. After such a stroke, irreversible disturbances in the functioning of the body are possible.

Recoverable Causes of Cerebral Stroke

Let's take a look at some of the causes of stroke in terms of correcting them.

  • Bad ecology. If you are not able to remove external factors, for example, move to another place, then at least partially reduce their negative impact. Spend more time in the fresh, clean air, strengthen the immune system, and exercise.
  • Heredity. Educate your children to a healthy lifestyle so as not to provoke disease.
  • Stress. Change your attitude towards stressful situations. Your nerves won't solve the problem.
  • Fatigue. Take regular outings. It has a beneficial effect on a person, energizes, relieves irritation. Use active recreation with physical activity. Get adequate sleep and adequate nutrition.
  • Eat plenty of fresh berries that contain bioflavonoids. In stroke, this vitamin is deficient.
  • Eliminate physical and emotional stress.
  • Get rid of excess weight, as it is the cause of many diseases, including stroke.
  • Keep your blood pressure normal. Use herbal remedies, proper nutrition.
  • An excess of salt in the body leads to an increase in blood pressure. Limit this product in your diet.
  • Vascular spasms. Refrain from strong emotions that can cause vasospasm.

In list causes of stroke there may be stress or emotion. As a rule, if negative emotions exceed positive ones, then stress becomes chronic. At the same time, any stress causes an increase in heart rate and blood pressure, which increases the cardiac load.

Causes hemorrhagic stroke, developing as a result of a deterioration in the elasticity of the vessel, is most often caused by their atherosclerotic changes. Expansion of blood vessels and thinning of their walls with a jump in blood pressure during a hypertensive crisis lead to a disastrous result.

Last time since Statistics show that the stroke is younger. Causes of stroke in young people people do not coincide with the causes of stroke in older patients. Most often, in young patients, cerebral hemorrhage is caused by changes in the cerebral vascular system at birth. To prevent hemorrhage, young people need to see a specialist. Our center has enough qualified specialists to prevent cerebral stroke, causes which does not always appear, especially at a young age. You do not need to be treated yourself using unverified folk remedies.

The main causes of stroke- This is a violation of blood supply, called ischemia, blockage of blood vessels by an embolus - embolism, thrombosis - the formation of blood clots, intracerebral hemorrhage. If a person with a stroke suddenly loses consciousness, this means that most likely human stem stroke, causes which consists in damage to the cerebellum, thalamic region. A cerebral hemorrhage usually develops suddenly with physical or emotional stress.

Stroke causes and consequences... especially relevant for young people whose habits are smoking and drinking. The consequence of a stroke is often a fixed gaze, dilated or narrowed pupils, memory impairment, strabismus, paralysis of speaking, decreased mental activity, and external personality changes.

Symptoms and Causes of Stroke often expressed, first of all, in the early appearance of pronounced vegetative disorders - pallor or redness of the face, a decrease followed by an increase in body temperature, sweating. An important cause of stroke, especially in young people, is bad habits.

A stroke is an arrest of blood circulation in the brain tissues with their subsequent necrosis. Major stroke- involvement in the process of a large volume of brain tissue. This is an increase in the fragility of blood vessels and their age-related changes.

Stroke causes and prevention. Unfortunately prevention this disease is often ignored by people. Today, there is an increase in the number of cases of post-stroke disability or death of a sick person. There are two ways medicine offers to prevent stroke: prevention and symptomatic treatment of the disease. Specialists of the Center of Nadezhda Loskutova are characterized by the statement “It is easier to prevent than to cure”.

... What are the main symptoms of a stroke?

Olga Ostroumova, professor of the Department of Clinical Pharmacology and Propedeutics of Internal Diseases at the 1st Moscow State Medical University named after M.V. I.M.Sechenova, Professor of the Department of Faculty Therapy, Moscow State University of Medicine and Dentistry, Vice-President of the Russian Medical Society for Arterial Hypertension:

- Everyone can avoid a stroke! The main thing is to know its symptoms and not to miss them!

One of the first signs of a stroke is numbness in an arm or leg.

Weakness in an arm or leg may be due to hemorrhage in the brain. Sometimes complete immobilization is possible.

The second important sign is speech impairment (sometimes it is just hard to speak - the corner of the mouth does not move or the asymmetry of the face appears, sometimes there is a complete loss of speech). A special insidiousness is that these symptoms can appear and disappear: the hand is weakened, porridge in the mouth, but after 10 minutes everything has passed - and people relax. And they miss a transient ischemic attack - this is essentially the same stroke. Therefore, you need to call the ambulance right away: even if you feel good by the time the doctors arrive, you need to talk about what happened and take action. In a common stroke, these symptoms persist for a long time.

The doctor of medical sciences, professor, deputy. Director of the Scientific Center of Neurology of the Russian Academy of Medical Sciences Mikhail Piradov:

Age has long been considered one of the leading risk factors for stroke. Every next decade of life after 20 years, scientists argued, approximately doubles the likelihood of developing vascular pathology of the brain.

Today, a stroke is getting younger from year to year. According to American researchers, the number of 40-year-olds who died from a stroke has recently increased by 200 (!) Percent. We have a lot of young victims of stroke as well. Among patients with acute cerebrovascular accident, there are also 20 and 30-year-olds. For some, the use of hormonal contraceptives became the trigger for the dangerous process, for others - a head injury, even just a sharp turn of the neck while driving. Genetic predisposition also plays an important role in the development of stroke. Not to mention the fact that it is young people who smoke more, consume more alcohol, and lead a richer, more stressful lifestyle. All this negatively affects their health.

Stroke at a young age

STROKE AT YOUNG AGE: DEFINITION OF STROKE AT YOUNG AGE; MAIN CAUSES OF STROKE IN YOUNG AGE; STROKE IN YOUNG AGE MAIN CAUSES; CONSULTATION OF A NEUROLOGIST AND EXAMINATION OF PATIENTS WITH STROKE IN YOUNG AGE; STROKE IN YOUNG AGE DIFFERENCE FROM OTHER DISEASES; TREATMENT OF STROKE PATIENTS IN YOUNG AGE

Stroke at a young age according to the WHO classification, it occurs in people aged 15 to 45 years. Ischemic strokes at a young age differs in a variety of the producing factor; stroke at a young age can be caused by vascular disease, cardiogenic embolism, haematological disorders, drug abuse, oral contraceptive pills, migraine, and many other more rare causes. Hemorrhagic stroke at a young age is manifested by subarachnoid, parenchymal and intraventricular hemorrhage and is caused by arterial hypertension, aneurysm, hemangioma, atherosclerosis, hemiphilia, systemic lupus erythematosus, eclampsia, hemorrhagic vasculibiasis. In some cases, the cause of a stroke remains unknown even with a comprehensive and conscientious examination by a neurologist of the patient with stroke at a young age .

STROKE IN YOUNG AGE MAIN CAUSES:

I. Hypertension (lacunar infarction)

II. Cardiogenic embolism (endocarditis, atrial fibrillation, myocardial infarction, artificial valve, aortic valve stems, etc.)

III. Vascular malformations

IV. Dissection of the carotid artery (trauma pseudoaneurysm)

V. Hypercoagulable states (systemic thrombosis in antiphospholipid syndrome, Snedon's syndrome, use of oral contraceptives, etc.)

Vi. Fibromuscular dysplasia (non-inflammatory segmental angiopathy of unknown etiology)

Vii. Moya-moya disease (non-inflammatory occlusive ip tracranial vasculopathy of unknown etiology)

VIII. Migraine infarction (migraine with aura)

IX. Vasculitis

X. Hematological disorders (polycythemia, dysglobulinemia, disseminated intravascular coagulation, etc.)

XI. Inflammatory diseases (rheumatoid arthritis, systemic lupus erythematosus, scleroderma, Sjogren's syndrome, periarteritis nodosa, Wegener's granulomatosis, sarcoidosis, etc.)

XII. Infectious diseases (neuroborreliosis, neurocysticercosis, Herpes zoster, bacterial meningitis, chlamydial pneumonia, hepatitis C, HIV infection)

XIII. Tumor cell embolism

XIV. Hereditary diseases (neurofibromatosis, epidermal nevus syndrome, autosomal dominant leukoencephalopathy with multiple deep small infarctions, Williams syndrome)

XV. Iatrogenic (treatment with high doses of female sex hormones, administration of L-asparagenase, high doses of intravenous immunoglobulin, interferon, etc.)

Hypertension and symptomatic arterial hypertension are the most common causes of ischemic (lacunar infarction) and hemorrhagic strokes. The latter also develop with such vascular anomalies as aneurysms and vascular malformations. Less often, hemorrhagic strokes develop as a complication of coagulopathy, arteritis, amyloid angiopathy, moyamoya disease, TBI, migraine and the use of certain drugs (cocaine, fenfluramine, phentermine). Described hereditary intracerebral hemorrhage (Dutch and Icelandic types).

Recognizing the causes of stroke at a young age requires from the neurologist the most painstaking study of the patient's medical history, targeted physical examination and the use of special methods for studying the cerebral circulation and the cardiovascular system.

Nowadays, lacunar infarctions are detected by computed tomography (but in the first 24 hours they may not be detected). Their size is variable from 1 mm to 2 cm. They develop due to destructive changes in the walls of the penetrating (intracerebral) arteries in hypertension and proceed either asymptomatically or in the form of characteristic syndromes: "purely motor hemiplegia" ("isolated hemiplegia or hemiparesis"), "Purely sensitive stroke" ("isolated hemihypesthesia"), "homolateral naxia and crural paresis" ("atactic hemiparesis"), "dysarthria and awkwardness in the hand." Less commonly, lacunar infarction can manifest itself in other syndromes.

A cerebral infarction at a young age can develop as a result of prolonged angiospasm with subarachnoid hemorrhage from an aneurysm. Cerebral infarctions developing at the height of a migraine attack (migraine infarction) are periodically described.

A source of cardiogenic embolism in stroke at a young age can serve: endocarditis, atrial fibrillation, recent myocardial infarction, akinetic segment of the myocardium, dilated cardiomyopathy, intracardiac thrombus or tumor, changes in heart valves in nonbacterial tombotic endocarditis, heart valve replacement, right-left shunt, heart aneurysm. Possible sources of embolism can also be: mitral valve prolapse, distant (in the past) myocardial infarction, left ventricular hypertrophy, hypokinetic myocardial segment, atrial septal defect, calcifying stenosis of the aorta or mitral valve, aneurysm of the Valsalva sinus.

Traumatic dissection of the carotid artery (dissection) may cause stroke at a young age with trauma (including mild and hyperextension) and unsuccessful manual therapy. It is also described as a spontaneous phenomenon in fibromuscular dysplasia, Marfan syndrome, type IV Ehlers Danlos syndrome, migraine and some other rare diseases.

A rare reason stroke at a young age is a moya-moya disease, which is manifested by a characteristic neuroimaging picture.

When vasculitis is detected in a patient with stroke at a young age it is necessary to clarify whether the process is limited only to the central nervous system (isolated angiitis of the central nervous system) or a systemic disease such as Takayasu disease, periarteritis nodosa, etc.

Hypercoagulable states (various variants of antiphospholipid syndrome, Sneddon's syndrome, oral contraceptive use, malignant neoplasm, insufficient antithrombin III, protein C, protein S, afibrinogenemia, pregnancy, malignant neoplasm, nephrotic syndrome, paroxysmal nocturnal hemoglobulinemia, homochematologic hematologic hematologic disorders (polycythemia, dysglobulinemia, sickle cell anemia, disseminated intravascular coagulation syndrome, leukoagglutination, thrombocytosis, thrombocytopenic purpura, protein C deficiency, protein S deficiency, fibrinolysis disorders) are a well-known cause of strokes at a young age. In the diagnosis of this circle of diseases, hematological (and immunological) studies are of leading importance.

Inflammatory systemic diseases (rheumatism, repatoid arthritis, systemic lupus erythematosus, scleroderma, Sjogren's syndrome, polymyositis, Henoch-Schonlein purpura, periarteritis nodosa, Schurg-Strauss syndrome, Wegener's granulomatosis, sarcoidosis), as well as isolated angiitis, can lead to stroke as a complication of the underlying disease. Diagnosis is facilitated by the presence of symptoms of a current systemic disease, against the background of which neurological cerebral symptoms develop sharply.

Stroke at a young age against the background of infectious lesions of the nervous system (neurocysticercosis, neuroborreliosis, bacterial meningitis, Herpes zoster, chlamydial pneumonia, hepatitis-C, HIV infection) also develop against the background of already existing clinical manifestations of somatic or neurological diseases, the diagnosis of which is crucial for identifying the nature of stroke ...

Tumor cell embolism is a rare cause stroke at a young age(as well as fatty embolism and air embolism) and in a significant percentage of cases remains unrecognized.

Hereditary diseases (homocystinuria, Fabry disease, Marfan syndrome, Ehlers-Danlos syndrome, elastic pseudoxanthoma, Rendu-Osler-Weber syndrome, neurofibromatosis, epidermal nevus syndrome, TsADASIL syndrome, Williams syndrome, Sneddon syndrome, mitochondrial encephalopathy-aulcidosis with lactate the so-called MELAS syndrome), which can lead to stroke, are confirmed by clinical and genetic analysis, characteristic neurological, cutaneous and other somatic manifestations.

Iatrogenic forms of stroke at a young age develop acutely in response to the introduction of certain drugs (high doses of female sex hormones, L-asparaginase, immunoglobulin, interferon and some others), which is the basis for suspicion of an iatrogenic origin stroke at a young age .

Studying medical history stroke patients at a young age... It is important for your neurologist to pay attention to the presence of risk factors for certain diseases or characteristic bodily symptoms that were present in the past, or are detected during a neurological examination in the present.

Several eye and skin symptoms are important. The likelihood of atherosclerosis as a possible cause stroke at a young age... increases in the presence of such risk factors as smoking, arterial hypertension, hyperlipidemia, diabetes mellitus, radiation therapy; Carotid dissection may be suspected if there is a history of trauma or manual manipulation of the neck.

A cardiac cause of stroke may be suspected if frequent intravenous drug use is found or an association stroke at a young age with physical exertion, deep vein thrombosis, heart murmur, heart valve surgery, bone marrow transplantation are found.

About the hematological cause stroke at a young age may speak: sickle cell anemia, deep vein thrombosis, reticular livedo, bone marrow transplantation. Sometimes the clue to the nature of stroke is information about the use of oral contraceptives, alcohol abuse, recent (within one week) febrile illness, pregnancy, HIV infection, myocardial infarction in the past, indications of stroke at a young age family history.

The presence of a "corneal arch" around the iris indicates hypercholesterolemia; corneal opacity may reflect Fabry disease; identification of Lisch nodules (Lisch) allows suspecting neurofibromatosis; subluxation of the lens - Marfan's disease, homocystinuria; retinal perivasculitis - sickle cell disease, syphilis, connective tissue disease, sarcoidosis, inflammatory bowel disease, Behcet's disease, Eales disease. Retinal artery occlusion can accompany cerebral embolism and multiple heart attacks; retinal angioma - cavernous malformation, Hippel-Lindau disease; optic nerve atrophy - neurofibromatosis; retinal hamartoma - tuberous sclerosis.

Examination of the skin can prompt or directly indicate a particular bodily or neurological pathology. Osler's nodules and traces of hemorrhage sometimes accompany endocarditis; xanthoma indicates hyperlipidemia; coffee-colored spots and neurofibromas - for neurofibromatosis; vulnerable skin with easy bruising and blue sclera - for Ehlers-Danlos syndrome (type IV); telangiectasias force to exclude Osler-Weber-Randu disease (hereditary hemorrhagic telangiectasia) and scleroderma; purple hemorrhages - coagulopathy, Henoch-Schonlein disease, cryoglobulinopathy; aphthous ulceration - Behcet's disease; angiokeratosis - Fabry disease; livedo reticularis - Sneddon's syndrome; facial angiofibromas - tuberous sclerosis.

NB: cerebral vein thrombosis is a rare complication of various diseases. Cerebral venous thrombosis can be aseptic and septic (infections of the frontal paranasal and other sinuses; otitis media; pregnancy; carcinoma; dehydration; state of marasmus; therapy with androgens, cisplatin, aminocapronic acid; intravenous catheterization; periarteritis nodosa; systemic lupus erythematosus; ; Behcet's disease; Degos disease; sarcidosis; nephrotic syndrome; chronic lung diseases; diabetes mellitus; TBI; some hematological diseases; disseminated intravascular coagulation; arteriovenous malformation; Sturge-Weber disease; idiopathic cerebral vein thrombosis).

STROKE IN YOUNG AGE PATIENT EXAMINATION:

Clinical blood test (platelet count, hemoglobin, red and white blood cell count, ESR), urinalysis, biochemical blood test (including potassium and sodium electrolytes, glucose, creatinin, urea, bilirubin, liver tests, ACT and ALT, cholesterol , triglycerides, etc.), plasma osmolarity, blood gas composition, acid-base balance, pregnancy test, HIV infection, antibodies to phospholipids, lupus anticoagulant, cryoglobulins; a coagulogram is examined with the determination of fibrinogen, fibrinolytic activity, thrombin time, prothrombin, hematocrit, blood coagulation time, antithrombin III, as well as the aggregation ability of erythrocytes, blood viscosity, toxicological study of blood and urine, Wasserman reaction, blood test for HBs antigen, CT or MRI, ECG (sometimes Holter ECG monitoring), EEG, radioisotope brain scan and blood flow study, ophthalmoscopy, various Doppler methods, lumbar puncture, blood culture, if indicated - carotid or vertebral angiography, immunological blood test, chest X-ray. The consultation of the therapist is shown.

STROKE IN YOUNG AGE DIFFERENCE FROM OTHER DISEASES: Other diseases with a stroke-like course can also be hidden under the mask of a stroke: multiple sclerosis, partial ("hemiparetic") epileptic seizures, brain tumor, brain abscess, subdural hematoma, brain contusion, migraine with aura, dysmetabolic disorders in diabetes mellitus.

FOR A FASTER AND ACCURATE SOLUTION OF THE QUESTION AND EFFECTIVE TREATMENT CONTACT YOUR DOCTOR NEUROLOGY IN VOLGOGRAD SERGEY YAKOVLEVICH BORZENKO

Heart attack, stroke at a young age

5. Lina | 05.08.2013, 14:35:48

Women are protected by hormones, which often happens to men. ECG, blood tests - biochemistry and clinical, gynecolologist, ultrasound of organs, dentist, etc. burn, hospital! I mean, don't worry!

The state of a stroke in any of its forms is always a state of a somatoneurological problem. Moreover, all of the above applies not only to stroke states that develop in adulthood or old age. First of all, such a description can be attributed to the states of stroke that occurs at a fairly young or even young age (namely, according to the classification of the World Health Organization, at the age of patients from fifteen to forty-five years).

Apoplectic stroke

Stroke that occurs at any age is an acute form of pathological disorders of cerebral circulation, accompanied by the death of brain tissue cells and corresponding functional disorders, which correspond to specific symptoms of the disease. A stroke that develops at either 20 or 30 or 45 years old (sometimes at a younger age) can be ischemic or hemorrhagic.

Further, we would like to cite statistical data on the development of stroke pathology in men and women, depending on the age of the patients. The diagram below clearly shows that a stroke, which not so rarely affects twenty or thirty-year-old people, does not spare anyone, although it occurs much more often in an older category of patients.

The development of cerebral stroke in patients of different ages

Various types of ischemic stroke that overtake patients at a fairly young age (20-30 years old) are distinguished by their etiological heterogeneity. What causes a stroke at the age of 25, why does it happen that apparently healthy young men and women face the state of ischemic stroke? The reasons that can cause this form of the disease at such a young age are:

  • Latent vascular diseases that are not always detected in a timely manner.
  • In the possible development of cardiogenic embolism.
  • Not detected in a timely manner hematological disorders.
  • Frequent abuse of drugs by patients, say, the same oral contraceptives that girls 20-30 years old prefer to use.
  • Development of migraine, etc.

The reasons why young patients may develop hemorrhagic stroke are in the development of:

  • Arterial hypertension.
  • Possibly aneurysms.
  • Sometimes hemangiomas.
  • The onset of atherosclerosis at a young age.
  • Diseases such as hemophilia, systemic lupus erythematosus, eclampsia, hemorrhagic vasculitis, venous thrombosis, Werlhof's disease.
  • When young people have a tendency to abuse strong drugs, for example, cocaine.

As a result, a hemorrhagic stroke that occurs at a young age (in patients 20-30 years old) is manifested by the development of subarachnoid, parenchymal, or intra-ventricular hemorrhage of different power.

The first signs and subsequent symptoms of such a condition in patients 20-30 years old are not too different from the manifestations of a stroke in an older group of people.

How different are the causes of cerebral stroke in younger patients?

Traditionally (both in young people, at the age of 20-30, and in older people over 50), the causes of stroke development can be enclosed in diseases that are familiar to many. Asking the question of what usually causes a stroke, many will answer without the help of doctors - from long-term progressive atherosclerosis, arterial hypertension, from cardiac arrhythmias, etc.

Hemorrhage due to cerebral stroke

In addition, many, without the help of specialists, will notice that the first risk factors for developing a brain stroke are prolonged smoking, a pathological tendency to constant use of alcohol or drugs. However, not many people know that today there are other reasons for the development of a stroke, which often cripple very young and even physically strong (relatively healthy) people aged 20-30.

So, the most common reasons why a cerebral hemorrhage (hemorrhagic stroke) can occur in patients aged 20-30 is the congenital nature of changes in the vascular system of the brain. These are conditions in which so-called aneurysms are formed - strictly specific sac-like protrusions of the walls of vital intracerebral arteries.

A little less often, but also there are specific arteriovenous type of malformation, when a fairly harmonious (physiologically correct) series of separation and branching of vessels of different orders is simply lost. As a result, the substance of the brain feeds a whole conglomerate of vessels, among which there may be some tangled tangles of physiologically defective, structureless vessels.

As a rule, the walls of aneurysms or those vessels that are susceptible to arteriovenous malformation are considered quite thin and brittle, and a physiologically normal increase in pressure (possible with stress, strong positive emotions, during physical exertion) can lead to rupture of those, to hemorrhage into the brain substance or under its shell.

Note that such congenital anomalies are the main reasons why patients aged 20-30 have a stroke.

In particular, if such anomalies were not noticed by doctors in a timely manner, they were not corrected, and the patient, considering himself absolutely healthy, received increased loads.

What is the difficulty of preventing brain stroke in young patients?

To our great regret, as most experts report, congenital aneurysms, as well as malformations of the cerebral arteries, can be completely asymptomatic for many years without disturbing patients. Symptoms and signs of such formidable anomalies that can lead to the development of a stroke at 20-30 years old can only occasionally appear in the form of episodic headaches. Sometimes the symptoms of these abnormalities can include periodic occurrence of tinnitus, pulsations in the veins of the head and neck, which, in fact, can alert an experienced neurologist.

Observation and examination by a specialist

But nevertheless, the treatment of a patient with such problems becomes possible only when the person himself is able to realize that such symptoms or signs of an ailment incomprehensible to him require the advice of an experienced specialist. To our great regret, as a rule, reaching 20 or even 30 years of age, no one thinks that such symptoms can indicate the development of a serious pathology. And moreover, few people understand that this may be the primary signs of a possible imminent development of a stroke.

Most of us can take such alarming signals (capable of provoking a stroke) for banal fatigue, after a hard day, or for general malaise associated, say, with a cold. Nevertheless, we emphasize, noticing such symptoms in yourself or your relatives of a young age, do not be lazy to contact a neurologist - perhaps the symptoms described will turn out to be really just your invention, and perhaps this is how you will save your life.

I must say that today, there are many methods of high-quality instrumental diagnostics (we are talking primarily about computer X-ray or magnetic resonance imaging), which allow to confirm or refute the fears that arise when such symptoms appear with the highest degree of accuracy.

Stroke: causes, symptoms, signs, first aid, prevention

80 percent of stroke patients become disabled, a third of them need outside help. Only 20 percent can return to their former life. What causes a person to have a stroke? Is it possible to avoid this formidable disease? The chief neurologist of the Agency for Healthcare and Pharmaceutical Provision of the Administration of the Krasnoyarsk Territory, Ph.D. Professor Svetlana Shetekaura.

Stroke is an acute disorder of cerebral circulation, which is based on disorders of the vascular system of the brain. This can be a rupture, spasm, or blockage of one of the vessels supplying blood to a part of the brain.

Hemorrhagic - (hemorrhage) - when a vessel ruptures and blood enters the cranial cavity. They account for 15-20 percent of all strokes. In young people (20-30 years old), hemorrhagic stroke often occurs as a result of a rupture of a cerebral vessel with a congenital anomaly, when the vessel is malformed while still in the womb (the so-called aneurysm). With excessive physical exertion, severe stress, even with a sharp tilt, such a vessel can rupture. At an older age, a vessel in the brain can rupture, unable to withstand high blood pressure (BP) - a hypertensive crisis. Hemorrhagic strokes are the most severe and with the highest mortality.

The rest of the strokes are ischemic, caused by insufficient blood supply to the brain as a result of vascular spasm or blockage of the vessel by a thrombus. The integrity of the vascular wall in this type of stroke is preserved, but the blood flow is reduced due to a decrease in its lumen. More often this happens with atherosclerosis, when the elasticity of the vessel wall is disturbed by fatty deposits - atherosclerotic plaques. They increase in size and close the lumen of the vessel. Or, blood clots form on their damaged surface, which close the lumen of the vessel. Ischemic strokes develop more often after 40-50 years.

Two diseases most often lead to strokes - hypertension and atherosclerosis. Hypertension is dangerous because in half of the cases this ailment is asymptomatic, that is, a person does not feel his high blood pressure, is not treated, and a stroke for him is like a bolt from the blue. Atherosclerosis is the leading cause of stroke in older people. In addition to these diseases, people suffering from diabetes mellitus, obesity, with increased blood clotting are at risk for strokes - they usually have a tendency to thrombus formation. Smokers are very at risk - obliteration (narrowing of the lumen) of the vessels occurs not only in the legs, but also in the brain. Those who abuse alcohol are also at risk. It is abused, since small doses of alcohol do not lead to strokes. The hereditary factor matters - more often strokes occur in those whose close relatives have suffered a stroke or heart attack. Special attention should be paid to those who often experience stressful situations, which, as a rule, are accompanied by a sharp rise in blood pressure, and the state of the vessels at this moment is unknown to the person - the vessel may not withstand stress.

Strokes develop to the same extent in men and women. In the age group up to 60 years, strokes occur twice as often in men, after 60 years - more often in women.

Often, before the patient develops a stroke, there may be signs of transient cerebrovascular accident. You should pay attention to them.

The first signs are the harbingers of a stroke:

- sudden, unexplained severe headache;

- dizziness, loss of balance or coordination;

- sudden weakness or numbness in a part of the body: face, tongue, torso, arm or leg, especially if it is on one side of the body;

- sudden deterioration of vision in one or both eyes;

- violation of consciousness, orientation in the environment;

- speech disorders.

These sensations come on suddenly and disappear after a few minutes or hours. In 30 percent of patients with such short-term ischemic attacks, a stroke of varying severity develops during the year. Therefore, do not expect that "it will pass by itself", you must immediately call an ambulance.

At the first signs of a stroke, before the arrival of an ambulance, you need;

- calm the patient down, put him to bed and insist on rest;

- measure blood pressure, if it is high and the patient knows about his hypertension, immediately take the drug, which he usually takes with high blood pressure;

- improve the flow of air: remove the patient from a stuffy, especially smoky room, open a window, unfasten the collar, that is, create conditions for a greater supply of oxygen.

It is forbidden!

Move sharply, get up. In such conditions, a person has psychomotor agitation, when the patient begins to move actively, this can dramatically worsen his condition.

With high blood pressure, in no case strive to drastically reduce blood pressure. Optimally, lowering blood pressure by 15-20 percent of the original.

Take antispasmodics: noshpa, papaverine and others.

The called "Ambulance" (as a rule, it is a specialized stroke team) will take the patient to the hospital.

The ambulance teams have in their arsenal the equipment and the necessary medications to help the patient before arriving at the hospital. The main thing is to be admitted to the hospital as soon as possible, where they will immediately prescribe the necessary treatment. Specialists have a concept - a "therapeutic window", when within 3-6 hours after a stroke, it is necessary to begin a complex intensive treatment, while the brain tissue has not yet died, which was left without blood supply during a stroke.

According to the severity, strokes are divided into mild, moderate and severe. A slight stroke is cured within three weeks of intensive therapy and ends well for the patient: the impaired functions are restored, there is no paralysis or speech disorders. The statistics of more severe strokes is pessimistic: every fifth patient dies, 80 percent remain deeply disabled. It is impossible to cure a severe stroke at this stage in the development of medicine, therefore stroke prevention is more important than treatment.

National measures for the prevention of strokes include active clinical examination of patients with diseases leading to stroke. Such patients should be under the constant supervision of doctors so that doctors can actively treat their disease, individually selecting the treatment.

But the means of individual prophylaxis are also of great importance.

Know your blood pressure. If you are healthy, measure it at least once a year. If you have a high-risk disease, especially hypertension, you should have a blood pressure monitor at home.

Monitor your weight. Be sure to consult with your doctor about how you personally deal with excess weight. Strive for a balanced diet with limited animal fats, salt and sugar, with a predominance of fruits, vegetables, lactic acid foods. For hypertensive patients, it is necessary to learn in detail and use a salt-free diet, for patients with atherosclerosis - a hypocholesterol diet.

If you have diabetes, strictly follow your doctor's recommendations for blood glucose control.

If you smoke, stop. Smoking doubles your risk of stroke.

For the prevention of recurrent stroke from the first days of an already onset stroke, a number of measures are carried out. It:

intensive treatment of diseases leading to stroke;

taking anticoagulants with increased blood viscosity, when the risk of thrombus formation is high: taking aspirin or aspirin-containing drugs (cardiomagnum) that do not work on the gastric mucosa;

taking drugs that improve cerebral circulation. These drugs are taken in courses in the future. In the first year after a stroke - it is obligatory twice a year, in the future - for health reasons, once or twice a year.

Material prepared by Nadezhda Frolova

Denis Pavlov: "Bad habits and overload can cause a stroke even at the age of 20"

Stroke can be called the "plague of the 21st century": it occurs annually in six million inhabitants of the planet.

In Russia, stroke affects almost half a million people a year and is in second place in terms of the number of deaths - about one in three dies.

Despite the scale of the disaster, few people think about the disease before it occurs. And in vain - after all, a stroke can be prevented. And if it happened, then with skillful rehabilitation, you can return to normal life.

Denis Petrov, a graduate of the Faculty of Adaptive Physical Education, has been assisting in the rehabilitation of people who have suffered a stroke since 2010.

- What types of strokes are there?

- Stroke can be ischemic and hemorrhagic. Recovery is possible after any type of stroke. With a hemorrhagic stroke, which is also called cerebral infarction, a hemorrhage occurs in the brain, different parts of it are affected. Ischemic stroke is a blockage of blood vessels by a blood clot.

- After what stroke is the maximum and quickest recovery possible?

- After an ischemic stroke, recovery is faster. Whether a person will be able to recover after a hemorrhagic stroke depends on the size of the focus of brain damage and on how correctly the person and the people around him will behave in the first hours after its onset, how quickly they will begin rehabilitation.

- Is it possible to find out about an impending stroke and are there any ways to prevent this disease in principle?

- Of course, it is possible, despite the fact that the disease is always unexpected. An increase in pressure, partial numbness - of the cheeks, arms of the legs, loss of sensitivity of different parts of the body, loss of fields of peripheral vision, violation of the symmetry of the nasolabial triangle may indicate his approach. Such conditions can occur unexpectedly and last for several minutes, and then go away by themselves. Do not underestimate the situation - these signs may indicate a transient ischemic attack, after which a full-fledged stroke can develop within a day, so hospitalization in no case should be refused. Often, simple drugs that thin the blood can save a person. If you just remember to control your blood pressure, as well as check your cholesterol and blood sugar levels once a year, you can already reduce the risk of a sudden stroke.

-What provokes a stroke, what are the main factors?

- High loads and overvoltages resulting in pressure surges are the most common causes. This also includes smoking, alcohol, stimulants. Heredity in this case is very important - if one of the relatives had a stroke, then the risk is great.

- And if a stroke did happen, what to do?

- In no case do not get up, call an ambulance. Within four hours after the onset of hemorrhage, there is a chance to prevent the lesion from reaching its maximum. This is the so-called therapeutic period.

- They say that a stroke is not so terrible as its consequences. Is there a chance after that to become a full-fledged person again?

- Rehabilitation helps in any case, it all depends on the size of the lesion in the brain and the amount of time that has passed since the stroke. It is best to start recovery immediately, the next day, gradually - you cannot give the body and muscles the opportunity to forget their normal state and habitual movements, including being horizontally in space. But people do not always understand this. If it did not work out right away, then within a year recovery with the return of all skills is possible. After a year, only the adaptation of a person to life in an already existing state is possible. And even the coolest specialist will not undertake the rehabilitation of a person who had a stroke two years or more ago.

- What mistakes in rehabilitation are most often made by people who have suffered a stroke and their relatives?

- The mistake is that many underestimate the importance of rehabilitation. Recovery from a hemorrhagic stroke should be started immediately. You can independently deal with the patient and follow the advice from the Internet, but in this case, no one guarantees that you will not harm the person.

- At what age should you be afraid of a stroke?

- Today - in any. As a rule, stroke is most likely after 40 years, but in my practice there have been 20-year-old patients who have undergone it. The stroke is "getting younger", which is facilitated by the peculiarities of ecology and nutrition - the use of salty, fatty foods, smoked meats, the use of alcoholic beverages, especially low-alcohol ones, and energy drinks. Exhaustion - both physical and emotional - can trigger a stroke at any age.

Photo from the personal archive of Denis Pavlov

Causes of stroke in young people

Historically, stroke has been considered a disease of old age. This opinion is fully justified, since the main cause of pathology is the blockage of cerebral vessels by an atherosclerotic plaque. However, in recent years, ischemic phenomena of the tissues of the central nervous system often occur at a young age, which is due to an increase in the frequency of occurrence of some provoking diseases.

Such diseases can be roughly divided into several main groups, such as:

  1. Pathological conditions accompanied by a change in the qualitative composition of the blood
  2. Tumors and other neoplasms

Pathology associated with a change in the composition of the blood

In the formation of "young" strokes, conditions such as polycythemia (a significant increase in the number of blood corpuscles relative to its liquid fractions), dysglobulinemia (a significant increase in the amount of proteins) and disseminated intravascular coagulation play a significant role.

Polycythemia (in the common people "thickening" of the blood) occurs in conditions of oxygen starvation, loss of a large amount of fluid. At the same time, the changed consistency of blood does not allow it to flow freely through the capillary network, which leads to blockage of small vessels and the formation of ischemic areas.

Dysglobulinemia in the form of an increase in the amount of proteins in the blood can also cause blood thickening with subsequent phenomena of oxygen starvation of the nervous tissue. As a cause of stroke, mainly quantitative dysglobulinemias are important.

DIC syndrome occurs in terminal patients with severe trauma and blood loss. This reaction is associated with the formation of a large number of microthrombi in the vascular bed and blockage of the capillary network. Strokes are formed only in the first stage of the development of disseminated intravascular coagulation. Further tendency to hemorrhage does not lead to vascular obstruction.

Diseases of the cardiovascular system

Today, the causes of stroke in young people often consist in the presence of hypertension, as well as organic vascular pathology. Hypertension can lead to the development of ischemia due to the lacunar effect, and to hemorrhagic strokes due to rupture of blood vessels.

Lacunar stroke is accompanied by the formation of cavities in the tissues of the brain, filled with cerebrospinal fluid. The process proceeds with the development of oxygen starvation in certain parts of the brain. The development of hemorrhagic stroke occurs against the background of reduced elasticity of the vascular wall in conditions of high blood pressure.

Organic vascular pathology can be a blood clot that clogs the lumen of the vessel, which leads to insufficient supply of oxygen to the brain and the death of its parts.

Inflammatory diseases of an infectious nature

The causes of stroke in young people may be hidden in the presence of certain infectious diseases. In this case, infections of the brain and its membranes (encephalitis, meningitis) are of particular importance in this case. In addition, ischemic events are sometimes observed in patients with tuberculosis.

The pathogenetic mechanism of the formation of the pathology under consideration in this case consists in a significant change in the biochemical composition of the blood, as well as in the direct effect of inflammatory phenomena on the vessels of the brain.

The role of tumors in the formation of stroke

The presence of growing tumors in the region of the brain can be the cause of both hemorrhagic and ischemic stroke. In this case, the development of disorders of cerebral circulation, as a rule, occurs gradually, as the tumor grows.

Hemorrhagic strokes develop when a malignant tumor grows through the blood vessels, which entails the development of venous or arterial bleeding, followed by the formation of an intracerebral hematoma.

Ischemic disorders occur more often in the presence of benign tumors that are not prone to proliferative growth. In this case, mechanical clamping of the vessel occurs without damaging the vascular wall. Similar processes are observed in intravascular tumors.

Acute disorders of cerebral circulation at a young age and in children

Strokes at the age of 15-40 years account for only 4% of all stroke cases. The incidence of stroke in children is even lower, at 2.5 cases per 100,000 children per year. At a young age (16-45 years old) and in children, the ratio of hemorrhagic and ischemic stroke reaches from 1: 1 to 1.5: 1, which indicates a higher incidence of hemorrhagic stroke than in older age groups.

The clinic of stroke at a young age and in children does not differ significantly; generalized or partial seizures are more common, and TIAs rarely precede the development of ischemic stroke. The examination and treatment of pediatric and young patients with stroke does not differ fundamentally, but they are carried out taking into account the specific causes of stroke at this age. In general, the prognosis of stroke is slightly better in children than in adults.

Ischemic stroke in children is much less likely to be caused by atherosclerosis and arterial hypertension than in adults. Comparatively often, cerebral infarctions are caused by heart diseases - congenital heart defects, rheumatic heart valve disease, significant mitral valve prolapse, non-overgrown foramen ovale, bacterial endocarditis, atrial myxoma, cardiomyopathy, arrhythmia. From 6 to 25% of all ischemic strokes in children are caused by hematological diseases - sickle cell anemia, leukemia, hypercoagulable conditions (antiphospholipid syndrome, protein C or S deficiency, antithrombin III deficiency, increased factor VIII levels), disseminated intravascular coagulation syndrome, thrombocythemia, polycythemia, thrombocytopenic purpura. Other diseases that often cause cerebral infarction in children include traumatic dissection of the carotid and vertebral arteries, congenital metabolic diseases (homocystinuria, Fabry disease, MELAS syndrome, etc.), vasculitis, and my-my disease.

At a young age, as in children, heart disease and hematological diseases remain common causes of stroke. Other causes include early atherosclerosis (often due to familial hypercholesterolemia), severe arterial hypertension and insulin-dependent diabetes mellitus. Oral contraceptive use is considered a risk factor for stroke in young women when combined with other risk factors for occlusive cerebral artery disease. Drug use (heroin, cocaine, lyzergic acid diethylamide, or LSD) can lead to the development of cerebral infarction due to their effect on the cerebral arteries (the development of inflammatory and non-inflammatory vasculopathies, severe vasospasm), the heart (the occurrence of arrhythmias, endocarditis) and the blood coagulation system (hypercoagulation). Migraine stroke accounts for about 5% of acute cerebrovascular accidents in persons under the age of 35.

Intracranial aneurysms (including mycotic aneurysms in infective endocarditis) are the most common cause of hemorrhagic stroke in children and young adults. Arteriovenous malformations are also a more common cause of hemorrhage than in older age groups. Other causes of hemorrhage can be hematological diseases (sickle cell anemia, hemophilia, leukemia, thrombocytopenia), primary and metastatic brain tumors, my-mine disease, intracranial vein thrombosis. In young children, the cause of intracranial hemorrhage may be a malformation of the great cerebral vein (an increase in the size of this vein with its varicose expansion or the formation of a venous aneurysm). At a young age, hemorrhage can be a complication of severe arterial hypertension and drug use (cocaine or amphetamine).

Ischemic stroke at a young age. Binswanger's disease

Incidence of ischemic stroke doubles with every decade of life (at the age of 45-55 it is 0.4% per year; at the age of 65 - 0.8%; at the age of 75 - 1.8%; at the age of 85 - 3.8% ). About 15% of all cases of ischemic stroke occur in people under 65 years of age. With increasing age, the proportion of ischemic stroke associated with atherosclerosis increases rapidly.

The young patients the causes of ischemic stroke are very diverse. Most often diagnosed with cardiogenic embolism, vascular dissection. in a significant number of cases, the cause of stroke remains unknown despite careful diagnostic search.

At stroke in young people, it is necessary to take into account the possibility of drug and alcohol abuse, as well as hypercoagulation caused by a deficiency of proteins C and S or antithrombin III or resistance to activated protein C.

Cerebral vein thrombosis and venous sinuses are more common in young women than in men, but generally rare (up to 1% of all cases of cerebral ischemia). Usually I hit a gay man with the upper longitudinal and lateral sinuses, less often with the primum, the cavernous sinuses and cortical veins. Clinical signs: headache, local or generalized epileptic seizures, edema of the optic discs, sensory and movement disorders. Etiology distinguishes between infectious (due to intracranial and systemic infections) and non-infectious thrombosis.

With differential diagnostics all conditions that can cause thromboembolic complications should be excluded, in particular, in women, the possibility of obstetric and gynecological diseases should be borne in mind, and in men - Behcet's disease. Neuroimaging techniques detect unilateral or bilateral infarctions. In most cases, thrombosis can be detected on contrast-enhanced CT or MRI; less often, angiography is required. The main diagnostic method is MRI.

Binswanger's disease

The bulk patients Binswanger's disease is associated with elderly lime trees with hypertension and other vascular risk factors. The causes may be other diseases accompanied by microangiopathy, for example, amyloid angiopathy. Clinical manifestations include lacunar infarction symptoms, pseudobulbar and extrapyramidal impairments, apathy and cognitive impairment that is on the rise! stepwise, alternating with periods of stabilization. Neuroimaging and postmortem examinations reveal multiple lacunar infarctions in the basal ganglia, thalamus, pons varoli and white matter of the hemispheres, as well as brain atrophy.

Amyloid angiopathy... Cerebral amyloid angiopathy is a disorder that occurs in old age. Occasionally, there are smaypy forms (Icelandic and Dutch types), in which young people are also affected.

Pathological anatomy... Pathological examination reveals amyloid deposits in small and middle cerebral arteries in the absence of signs of systemic amyloidosis, as well as changes of the Alzheimer's type, such as nsvritic plaques and neurofibrillary glomeruli

Clinical picture... Amyloid angiopathy manifests itself either with progressive lementia or recurrent lobar hemorrhages with acute focal neurological symptoms and, ultimately, with the development of dementia.

Diagnostics... Neuroimaging techniques produce the same changes as in Binevanger's disease. In addition, multiple subcortical hemorrhages with different ages are often noted. A reliable diagnosis can be made only with the help of a biopsy study, however, in elderly patients with two or more lobar hemorrhages and microangiopathic changes on MRI, the diagnosis of amyloid angiopathy is very likely. Treatment methods have not been developed.