Incidence and Short-Term Outcome of Cerebral Infarction in Young Adults in Western Norway

Abstract

Background and Purpose-We sought to determine the incidence and short-term outcome of people aged 15 to 49 years with first-ever cerebral infarction in 1988 -1997 in Hordaland County, Norway. Methods-Cases were found from computer search of hospital registries and detailed review of patient records. Stroke subtype was classified according to the major intracranial artery affected. Short-term outcome was evaluated by the modified Rankin Scale (mRS). Results-A total of 96 women and 136 men met the inclusion criteria. The average annual incidence was 11.4/100 000.Women outnumbered men among those aged Ͻ30 years (Pϭ0.059); men predominated among those aged Ն30 years (Pϭ0.004). A total of 148 patients had anterior circulation infarction (64%), and 84 had posterior circulation infarction (36%) (PϽ0.001). Patients with posterior circulation infarction had better mRS score at discharge (Pϭ0.005). Eighty percent had favorable outcome (mRS score Յ2). The 30-day case fatality rate was 3.4%. The recurrence rate in hospital was 2.2%. Key Words: cerebral infarction Ⅲ incidence Ⅲ outcome Ⅲ young adults T he incidence of ischemic stroke increases with age, but the incidence among young adults is not negligible. We sought to determine the average annual incidence rate of first-ever cerebral infarction, classify stroke subtypes, and evaluate the short-term outcome of people aged 15 to 49 years in a well-defined population. To our knowledge, this is the first population-based report on short-term functional outcome of cerebral infarction in young adults. Conclusions-The Subjects and Methods PatientsAll patients aged 15 to 49 years with first-ever cerebral infarction during 1988 -1997 living in Hordaland County, Norway, for at least 5 years before the stroke occurred were included. Cases were found by computer search from hospital registries at each of the 5 acute care hospitals in the county. The searching criteria were patients admitted to either an inpatient or an outpatient department and discharged with a diagnosis of primary or secondary stroke: categories 430 to 438 of the International Classification of Diseases, Ninth Revision.Cerebral infarction was defined in accordance with the BaltimoreWashington Cooperative Young Stroke Study Criteria. 1 This definition includes patients who have neurological deficits lasting Ͼ24 hours because of ischemic lesions and patients with transient ischemic attacks in whom CT or MRI shows infarctions related to the clinical findings. We excluded patients with cerebral infarction associated with other intracranial diseases such as subarachnoid hemorrhage, sinus venous thrombosis, or severe head trauma. Case selection and classification were based on the examination of the neurologist in charge of treatment and follow-up of the patient as well as critical review of patient records.Stroke subtypes were categorized according to the intracranial artery involved on the basis of the neurological deficits and CT or MRI findings.Neurological deficits on admission and discharge were categorized into no...

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