Ischemic Stroke in Young Tunisian Adults

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Published Apr 6, 2024
https://doi.org/10.62438/tunismed.v102i4.4460
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Vol. 102 No. 4 (2024): Tunis Med apr 2024

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Dhaker Turki
Laboratory of neurogenetics, Parkinson’s disease and cerebrovascular disease (LR-12-SP-19),Clinical Investigation Center (CIC), Habib Bourguiba university Hospital, university of Sfax, Sfax, Tunisia
Salma Sakka
Laboratory of neurogenetics, Parkinson’s disease and cerebrovascular disease (LR-12-SP-19), Habib Bourguiba university Hospital, university of Sfax, Sfax, Tunisia
Lamia Mbarek
Laboratory of neurogenetics, Parkinson’s disease and cerebrovascular disease (LR-12-SP-19), Habib Bourguiba university Hospital, university of Sfax, Sfax, Tunisia
Faten Triki
Department of cardiology, Hedi Cheker hospital, Sfax university, Sfax, Tunisia.
Mounir Ben jmea
Department of infectious diseases, Hedi Cheker Hospital, Sfax University, Sfax, Tunisia.
Khadija Moalla
Laboratory of neurogenetics, Parkinson’s disease and cerebrovascular disease (LR-12-SP-19), Habib Bourguiba university Hospital, university of Sfax, Sfax, Tunisia
Sameh Marzouk
Department of internal medicine, Hedi Chaker hospital, Sfax, Tunisia.
Olfa Turki
Department of intensive care, Habib Bourguiba university hospital, Sfax university, Sfax, Tunisia.
Fatma Megdiche
Laboratory of hematology, Habib Bourguiba university hospital ,Sfax ,Tunisia
Choumous Kallel
Laboratory of hematology, Habib Bourguiba university hospital ,Sfax ,Tunisia
Mariem Damak
Laboratory of neurogenetics, Parkinson’s disease and cerebrovascular disease (LR-12-SP-19), Habib Bourguiba university Hospital, university of Sfax, Sfax, Tunisia
Chokri Mhiri
Laboratory of neurogenetics, Parkinson’s disease and cerebrovascular disease (LR-12-SP-19),Clinical Investigation Center (CIC), Habib Bourguiba university Hospital, university of Sfax, Sfax, Tunisia

Abstract

Introduction: Ischemic Stroke in young adults is a real public health problem; it’s a major cause of disability, alters quality of life and has a great socio-economic impact.


Aim: determine risk factors and specify the etiology of arterial ischemic stroke in young Tunisian adults.


Methods: In this 5 years retrospective study (2015-2020), we included all young adults (18-50 years) admitted for arterial ischemic stroke (AIS). Risk factors were registered and analyzed. All patients were investigated using a standard protocol: biological tests, brain imaging, carotid ultrasound and cardiac assessment. Additional investigations were carried out at the discretion of the treating physician. The cause of ischemic stroke was classified according to the TOAST criteria.


Results: We collected 200 patients with AIS. The mean age was 41.37 years ± 6.99. Traditional vascular risk factors were observed in more than 1⁄4 patients. A definite cause of stroke was identified in 120 patients. Cardio-embolic causes were the most common among our patients (19%) followed by atherosclerosis of the large arteries (11.5%). Other determined etiologies were found in 27.5% of patients. The etiology remained unclear in 40% of cases: undetermined despite complete investigation in 17.5%, undetermined and incompletely investigated 14.5 % and more than one potential pathomechanisms in 8%.


Conclusion: Through this study, we demonstrated the diversity of etiology of stroke in young Tunisian adults. Changes of lifestyle are responsible for the occurrence of the traditional risk factors at an early age. Rheumatic heart diseases remain a frequent cause of AIS in our area.

Keywords:

Arterial ischemic stroke, young adults, stroke etiology, risk factors prothrombin, G20210A mutation.

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