Eur Stroke J. 2026 Feb 9;11(2):aakag003. doi: 10.1093/esj/aakag003.
ABSTRACT
INTRODUCTION: Arterial ischaemic stroke (AIS) in adolescents and young adults differs from older populations due to its variety of risk factors and aetiologies. This study compares the risk factor profiles and age- and sex-related differences between adolescents and very young adults.
PATIENTS AND METHODS: Pooled data from three multicentre cohort studies in Europe (Germany, France, The Netherlands) were analysed. First-ever symptomatic AIS cases in adolescents (10-18 years) and very young adults (18-30 years) were classified using both a paediatric AIS classification (multiple risk factor category system) and the modified Trial of ORG 10172 in Acute Stroke Treatment criteria for adults.
RESULTS: The cohort includes 142 adolescents (median age 15) and 131 very young adults (median age 25). Using the adult AIS classification, cryptogenic stroke was most common (43% in adolescents, 32% in young adults). Thirty-two percent had other determined aetiologies. The paediatric classification showed similar results regarding identified causes; 29% resulted in cryptogenic stroke, respectively. Sex distribution differed by age: male predominance in adolescents (61%) and female predominance in young adults (57%).
DISCUSSION: Adolescence and young adulthood may represent a shared age group with similar causes and risk profiles for AIS. The high rate of cryptogenic stroke suggests potential limitations in current classification systems for AIS aetiology at these ages.
CONCLUSION: This cohort highlights the need for an age-adapted risk factor system that accounts for the transitional nature and the complexity of stroke in this age group.
PMID:41701754 | DOI:10.1093/esj/aakag003