Cerebral Infarction in Young Women: Analysis of 130 Cases

Abstract

The aim of this study was to determine the risk factors and mechanism of cerebral infarction in young women. Methods: We evaluated 130 consecutive women younger than 41 years of age with cerebral infarction and compared the risk factors with a control group of 122 healthy, age-matched women. Results: The leading risk factors in patients with cerebral infarction were migraine (15%), tobacco use (15%), and oral contraceptive (OC) use (12%). Cerebral arteriograms were abnormal in 59% of patients (57 of 96). The causes of cerebral infarction were cardiac embolism in 36%, nonatherosclerotic vasculopathy in 25%, hematologic disorders in 8%, and migraine in 8%. The etiology could not be determined in 23% of patients. Conclusion: Migraine and OCs are independent risk factors for cerebral infarction in young women. The leading etiologies were rheumatic valve disease and nonatherosclerotic vasculopathy, hematologic disturbances, and migraine were responsible for a few cases.

Risk of ischemic stroke associated with low-dose oral contraceptive use: a meta-analysis

“…Among the selected studies, six 4,[6][7][8]14,15 were conducted in Europe, one 9 in the US, one 16 in Mexico, and one 5 in Europe and developing countries in Asia, Africa, and Latin America. Three studies 5,7,14 involved participants from more than one country.…”

“…All the studies were conducted since 1985 and published since 1993. Five studies 4,6,8,9,15 used population control, three 5,14,16 used hospital control, and one 7 used both. Age distribution of study subjects ranged from 11 to 49 years old.…”

“…Two studies 15,16 did not state estrogen dose explicitly. As for the study outcome, seven studies [4][5][6][7][8]15,16 reported ischemic stroke and two studies 9,14 reported both ischemic and hemorrhagic stroke.…”

“…In most studies, exposure to OCs was measured by mailing questionnaires 4,6,8 or personal interviews. 5,7,9,14 One study 16 did not report how they obtained the information on OC exposure and one study 15 used General Practice Research Database which is an automated national database collected for research purpose and contains medical and prescribing records for more than 8.5 million people throughout the UK. With regard to outcome ascertainment, four studies 7,8,15,16 used a combination of clinical and radiological diagnosis, whereas five studies 4-6,9,14 used only clinical diagnosis.…”

“…[4][5][6][7]9,[14][15][16] Age was adjusted in three studies [6][7][8] and socioeconomic status was adjusted in two studies. 6,14 Smoking was adjusted in eight studies [4][5][6][7][8][9]14,15 and hypertension was adjusted in seven studies.…”