Introduction. Stroke in people under 45 years of age is less frequent than in older populations but has a major impact on the individual and society. In this article we provide an overview of the epidemiology and etiology of young stroke. Methods. This paper is based on a review of population-based studies on stroke incidence that have included subgroup analyses for patients under 45 years of age, as well as smaller community-based studies and case-series specifically examining the incidence of stroke in the young. Trends are discussed along with the relative frequencies of various etiologies. Discussion. Stroke in the young requires a different approach to investigation and management than stroke in the elderly given differences in the relative frequencies of possible underlying causes. It remains the case, however, that atherosclerosis contributes to a large proportion of stroke in young patients, thus, conventional risk factors must be targeted aggressively.

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Abarbanel (1945) has pointed out, the process of ageing can become manifest in various organs at varying times, and just because the testis may be one of the last to succumb does not mean that it has now become the site of a pathological process while a similar state in the ovary is merely physiological.Summary It is considered that the male climacteric is a definite clinical entity, for the following reasons: (1) Similar symptoms occasionally occur in post-pubertal castrates and eunuchoids and are improved by androgen therapy.(2) The 17-ketosteroid secretion, while by no means diagnostic of testicular insufficiency, tends to be low. (3) Some of the symptoms can be explained by lack of the anabolic action of testosterone. (4) The urinary excretion of gonadotrophin is raised-indicative of testicular, but not necessarily of androgen, insufficiency. (5) The testicular histology may show structural changes. (6) The symptoms are improved with androgen therapy, but relapse when an inert substance is substituted. (7) Arguments similar to those advanced against the concept of a male climacteric could be raised against the existence of a female climacteric, which, however, has never been questioned.

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