Long-term outcome of cerebral infarction in young adults

Objectives - We analysed the long-term outcome of 232 young adults aged 15-49 years with first-ever cerebral infarction in 1988-1997 in western Norway. Material and methods - Mortality, recurrence, epilepsy, functional state as evaluated by modified Rankin scale (mRS), and employment were analysed at follow-up (mean time 5.7 years). Results - Twenty-three (9.9%) patients had died. Recurrence occurred in 9.9%, and post-stroke seizures developed in 10.5%. Recurrence was associated with diabetes mellitus (P = 0.005). Favourable functional outcome (mRS = 2) was found in 77.9%. The functional outcome was better in posterior than anterior circulation infarctions (P = 0.011). Unfavourable functional outcome (mRS > 2) was associated with diabetes mellitus (P = 0.001) and severity of neurological deficits on admission for the index stroke (P < 0.001). Only 58.3% were employed at follow-up. Conclusion - This population-based study shows that, although the majority had favourable functional outcome, cerebral infarction had major long-term impact on young adults as evaluated by mortality, recurrence and employment status.