Diagnostic Work-Up

Ischemic stroke in young adults (15-45 years) is relatively frequent, accounting for more than 10% of all first ischemic strokes). Its causes are heterogeneous and while it generally has a good prognosis, it has a significant socioeconomic impact, including functional deficits and financial costs. An accurate etiological diagnosis is crucial for preventing new episodes and additional functional deficits. Currently, the most frequent causes of ischemic stroke in young adults are cardioembolism, premature atherosclerosis, dissection of extracranial arteries, migraine, drugs and hypercoagulable states . However, it has not always been like this, as previously undetermined etiology was by far the most prevalent. Although still common, undetermined etiology is now less frequent as a result of diagnostic improvements. Diagnostic workup has changed dramatically over the last 3-4 decades . Since 1990s, procedures such as transesophageal echocardiography, hypercoagulability testing and magnetic resonance have been included in the systematic diagnostic protocol for stroke in young adults. A significant percentage of patients continue to be diagnosed with undetermined etiology even after extensive evaluation.

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Last date updated on September, 2024