Etiological patterns of stroke in young patients at a tertiary care hospital.

OBJECTIVE To observe frequency of various causes of stroke in patients of young (15-35 years) age. METHODS This Descriptive case series study was conducted in all Medical Units of Liaquat University Hospital (LUH) Jamshoro, Hyderabad, from August 2006 to February 2008 and included 50 patients of stroke aged 15-35 years, irrespective of sex and community. Data of these patients was collected through a pre-designed proforma by completing a comprehensive history, detailed examination and carrying out basic and relevant investigations. Patients suffering from hypoglycaemia, space occupying lesions, transient ischaemic attack or psychosis were excluded from the study. The collected data was analyzed on SPSS version 16.0. RESULTS Out of total number of 113 acute strokes, 50 patients fulfilling inclusion criteria were selected, comprising 30 males and 20 females. Forty-three (86%) patients suffered from ischaemic strokes while seven (14%) had haemorrhagic strokes. Infective meningitis including Tuberculosis meningitis and Bacterial meningitis was the leading cause of stroke (34%). The second most common cause was cardio-embolism (20%) comprising Valvular heart diseases (14%), Cardiomyopathies (4%) and atrial myxoma (2%).Hypertension was found in 14% cases. Pregnancy related causes (including Pregnancy induced hypertension and puerperal sepsis) were 12%. Systemic lupus erythematous and nephritic syndrome was 4% each. Various causes which constitute 4% or less were grouped together as miscellaneous and they include hyperhomocysteinaemia, and hyperlipidaemias. CONCLUSIONS Common cause of stroke detected was infective meningitis (Tuberculosis and Bacterial). Predominant cause of haemorrhagic stroke was Hypertension. Stroke in young age occurred predominantly in males. Cardio embolism, pregnancyinduced hypertension and puerperal sepsis were other major causes.