Strokes in the Young

Of 407 consecutive patients with cerebrovascular disease seen from July 1967 to June 1969 in a prospective study of stroke being conducted by the Department of Neurological Sciences at Christian Medical College Hospital, Vellore, South India, 127 (32%) patients were between the ages of 11 and 40, Using the standard criteria for diagnosis, 50% of the patients had cerebral thrombosis, 13% had cerebral embolism, 13% had internal carotid artery thrombosis (a subcategory of cerebral infarction), and the remainder were distributed through the other categories of cerebrovascular disease. Hypertension appeared to be a factor in about 19% of the patients (angiography revealed that the small intracranial vessels were more commonly abnormal than the larger extracranial arteries). Less than 10% of the patients had intracerebral hemorrhage or subarachnoid hemorrhage. The question was raised as to the possible role of arteritis secondary to common tropical diseases in the pathogenesis of these "strokes in the young."