Stroke in Young Adults: Experience at Abakaliki South East Nigeria

Abstract

Objectives: Stroke is a major cause of morbidity and mortality worldwide. It is increasingly common from the sixth decade, but is particularly tragic when it occurs in young adults. There are limited studies of stroke in young adults in Nigeria. It is against this background that we embarked on this prospective hospital based study to determine the epidemiology, pattern and case fatality rate of stroke in young adults in Abakaliki Southeastern part of Nigeria. Patients and Method: The stroke patients between the ages of 18 - 50 years admitted to the medical wards of a tertiary health centre at Abakaliki Nigeria from 1st August 2012 to 30th April 2019 were consecutively recruited. They were followed up till discharge. Relevant data like biodata, and clinical features of the patients were extracted and analyzed. Results: A total of 983 (males—511, females—472) stroke cases were seen with 197 between 18 - 50 years. One hundred and fifty two (77%) did neuroimaging (mean age—40.7 years). Eighty-eight (57.9%) had Cerebral infarct (males—42, females—46) while 64 (42.1%) had Hemorrhagic stroke (males—35, females—29). For those that had hemorrhagic stroke, 11 (17.2%) were Subarachnoid hemorrhage (SAH) while 52 (82.8%) were Intracerebral hemorrhage (ICH). The identified risk factors range from hypertension, DM, dyslipidemia, alcoholism, cigarette smoking, HIV infection and chronic use of coffee drinks. Sixteen patients died during the admission with case fatality rate of 10.5%. Conclusion: Stroke is actually prevalent in young adults as 1 in every 5 stroke patients seen was a young adult. In addition to the traditional risk factors, HIV/AIDS and chronic use of coffee drinks were also noted as emerging risk factors. There is need for a continuous health education and strong campaign on primary stroke prevention. Also, there is need for training of more neurologists with interest in stroke management and establishing comprehensive stroke centers at national, regional and local levels in order to contend adequately with the rising burden of stoke in young adults.