Article Text

Ischaemic stroke in young adults: a global perspective
  1. Esther Boot1,
  2. Merel Sanne Ekker1,
  3. Jukka Putaala2,
  4. Steven Kittner3,
  5. Frank-Erik De Leeuw1,
  6. Anil M Tuladhar1
  1. 1 Department of Neurology, Radboud Univerisity Medical Centre, Donders Institute for Brain, Cognition and Behaviour, Centre for Neuroscience, Nijmegen, The Netherlands
  2. 2 Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
  3. 3 Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA
  1. Correspondence to Anil M Tuladhar, Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Cente, Nijmegen 6525 GC, The Netherlands; Anil.Tuladhar{at}


Ischaemic stroke at young age is an increasing problem in both developing and developed countries due to rising incidence, high morbidity and mortality and long-term psychological, physical and social consequences. Compared with stroke in older adults, stroke in young adults is more heterogeneous due to the wide variety of possible underlying risk factors and aetiologies. In this review, we will provide an overview of the global variation in the epidemiology of stroke in young adults, with special attention to differences in geography, ethnicity/race and sex, as well as traditional and novel risk factors for early-onset ischaemic stroke, such as air pollution. Understanding global differences is an important prerequisite for better region-specific prevention and treatment of this devastating condition.

  • stroke
  • clinical neurology
  • epidemiology
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  • EB and MSE contributed equally.

  • Contributors EB and MSE drafted the first version of the manuscript with F-EDL and AMT. EB, MSE, JP, SK, F-EDL and AMT all participated in editing the manuscript. EB, MSE, JP, SK, F-EDL and AMT all edited the revised version of the manuscript and approved the final version for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AMT is a junior staff member of the Dutch Heart Foundation, project title: “life after ischaemic stroke in young adults” (grant number 2016T044). F-EDL has received the Innovational Research Incentive grant (016-126-351) and the Clinical established investigator Dutch Heart Foundation grant (2014T060). JP has received funding for research on stroke in the young from the Academy of Finland (318075) and Helsinki and Uusimaa Hospital District (TYH2018318). SK effort on this project was partly supported by VA RR&D N1699-R and NINDS R01NS100178 and R01NS105150.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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