What You Need to Know:
Last week American actor Luke Perry died at age 52 from complications of a massive stroke. This tragic event has prompted many to inquire about stroke and take a closer look at risk factors, especially those in the younger population.
Stroke is the fifth leading cause of death and is the number one cause of disability in the United States, yet 80% of strokes are preventable. While most strokes occur in persons over age 60, up to 10% affect persons under age 45.
A stroke occurs when blood flow to the brain is interrupted, either by a blood clot (ischemic) or a ruptured blood vessel (hemorrhagic). Atherosclerosis is the primary cause of stroke and may develop in patients with hypertension, diabetes, cigarette smoking, hyperlipidemia, or a positive family history.
Illicit drug use is associated with stroke and is a risk factor to consider, especially in younger patients. Cocaine use may cause stroke by way of platelet activation, vasospasm, and significant acute hypertension, which may lead to rupture of an aneurysm or arteriovenous malformation. Intravenous drug use can lead to ischemic stroke due to bacterial endocarditis. Recreational marijuana use is also associated with stroke, although it has not been established as a causative factor.
Certain diseases pose an increased risk for stroke, including the vasculitides and hypercoagulable states such as those found in moyamoya syndrome, sickle cell disease, and myeloproliferative disorders. Fibromuscular dysplasia is a cause for stroke in younger patients and predominantly occurs in women. Valvular heart disease and atrial fibrillation are risk factors for ischemic stroke. Carotid or vertebral artery dissection are additional causes of stroke in persons under age 50. Click here for a complete list of conditions associated with stroke.
Read More About Stroke:
Harrison’s Principles of Internal Medicine, 20e: Chapter 420. Ischemic Stroke
Principles and Practice of Hospital Medicine, 2e: Chapter 209. Transient Ischemic Attack and Stroke
Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e: Chapter 167. Stroke Syndromes