What Causes Stroke in Young People?

You might think of stroke as something that only affects older adults — and in many cases, that’s true. But about 10% to 15% of strokes happen in younger people.

There are two main types of stroke. The first, called an ischemic stroke, is the most common. It happens when blood flow to the brain is blocked — often by a clot. The second type, hemorrhagic stroke, happens when a blood vessel in or near the brain ruptures and bleeds.

Preventing Stroke in Younger Adults

Many of the same risk factors that affect older adults can also raise stroke risk in younger people. These include high blood pressure, diabetes, high cholesterol, inactivity, obesity, tobacco use and ongoing stress.

The encouraging news: most strokes are preventable. Regular checkups — and small, consistent steps — can go a long way toward protecting your health.

Here are some ways to lower your risk:

• Know your numbers. Keep track of your blood pressure, blood sugar and cholesterol. If they’re high, work with your provider to bring them into a healthy range.
• Eat with intention. Aim for a diet rich in vegetables, fruits, whole grains and healthy fats, with smaller amounts of lean protein.
• Stay active. Try to get at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise each week.
• Limit alcohol and avoid tobacco and drugs. This includes stimulants like cocaine, amphetamines and PCP, which can significantly raise stroke risk.
• Consider screening for sleep apnea. Untreated sleep apnea can affect your cardiovascular health.
• Manage stress. Chronic stress can take a toll on your body over time, including your heart and blood vessels.

Other Causes of Stroke in Young People

Lifestyle factors aren’t the only contributors. Some strokes in younger adults are linked to underlying medical conditions — some inherited, others acquired.

Heart Conditions

Certain heart conditions can increase stroke risk. In some cases, a clot forms in the heart and then travels to the brain through the bloodstream.

One example is patent foramen ovale (PFO), a small opening in the heart that doesn’t fully close after birth. About 1 in 4 people have a PFO, and while most will never have problems, a small number of strokes in younger adults are linked to it.

Because complications are uncommon, routine screening or treatment for PFO isn’t typically recommended unless there are specific concerns.

Artery Tears

Another possible cause is a tear in the lining of a blood vessel in the neck, known as a dissection. This can happen spontaneously or after even mild trauma, such as sudden neck movement or overextension.

A tear can narrow the artery and lead to clot formation, which may then travel to the brain. Early symptoms often include new, unexplained pain on one side of the head or deep neck pain. If you notice this, it’s important to seek medical attention.

Aneurysms

An aneurysm occurs when a blood vessel wall weakens and bulges outward. If it ruptures, it can cause a hemorrhagic stroke.

Some people are born with conditions that increase their risk, while others may develop aneurysms over time. Although they can occur at any age, ruptures are most common between ages 30 and 60.

A sudden, severe “thunderclap” headache — especially one that comes out of nowhere — is a medical emergency and should be evaluated immediately.

If you have a family history of aneurysms, talk with your doctor. Smoking and uncontrolled high blood pressure can significantly increase the risk of rupture.

Blood Disorders

Certain blood-related conditions can also increase stroke risk. These include inherited disorders like sickle cell disease, as well as autoimmune conditions such as antiphospholipid syndrome.

Some medications, including estrogen-based birth control and anabolic steroids, are also associated with a higher risk of blood clots. If you’re considering these treatments, it’s worth having a conversation with your doctor about your individual risk.

BE FAST to Spot a Stroke

If you have signs or symptoms of stroke, you need to get evaluated right away. Time is critical, so remember BE FAST:

• Balance: Loss
• Eyes: Vision changes
• Face: Drooping
• Arm or leg: Weakness
• Speech: Difficulty
• Time: Don’t wait. Call 911.