Acute ischemic stroke is catching them young

Compared with stroke in older adults, stroke in young adults is more heterogeneous due to the wide variety of possible underlying risk factors and aetiologies, warns Dr Guruprasad Hosurkar

The incidence of ischemic stroke in young adults is becoming a cause for concern and the sudden death of Kannada star Puneeth Rajkumar has brought back the focus on our weak hearts. Here’s an overview of what an ischemic stroke can do to our hearts.

An ischemic stroke occurs when a blood clot blocks or narrows an artery leading to the brain. A blood clot often forms in arteries damaged by the buildup of plaques (atherosclerosis). It can occur in the carotid artery of the neck as well as other arteries. This is the most common type of stroke. A stroke occurs when the blood supply to a part of the brain is obstructed due to rising incidence, high morbidity and mortality and long-term psychological, physical and social consequences. Compared with stroke in older adults, stroke in young adults is more heterogeneous due to the wide variety of possible underlying risk factors and aetiologies.

The brain needs a constant supply of oxygen and nutrients to function. As a result, brain cells begin to die within a matter of minutes, causing irreversible brain damage, long-term disability, or early death. There is one stroke happening every 40 seconds, one stroke related to death every four minutes making it the second most common cause of death in India. It is a debilitating condition that affects millions of Indians, yet there is a lack of awareness regarding this condition.

Is it only a disease of the elderly?

The number of stroke patients is rising at a rapid rate and contrary to the general opinion that it is a disease of the elderly, ischemic stroke is a condition that can occur at any age. Even though increasing age has been shown to have a strong association with the occurrence of stroke, there is no such thing as being too young for a stroke. Of course, its incidence increases with age, but it has been observed to increasingly affect young people. This tendency can have multiple consequences.
Since it targets the young working population, economic and social burdens are known to appear.

How does stroke affect the young?

It is believed that in developing countries, stroke occurs 15 years earlier when compared to developed countries. Indian studies have shown that about 10% to 15% of strokes occur in people below the age of 40 years. Mortality is up to four times higher in young adults with stroke as compared to healthy adults in the same age group. This is further complicated by the presence of other associated risk factors like hypertension, high cholesterol, diabetes, smoking, illicit drug use, heavy
alcohol drinking, obesity; which all add up to the increased risk of developing stroke in the young. This can have a lasting impact since a stroke in young patients may leave them disabled during their most productive years and can have a very negative impact on them and their families.

Is all lost for a young adult with a stroke?

Strokes are time-sensitive emergencies, as approximately two million brain cells die every minute a stroke is untreated, increasing the risk of disability or death. Time loss is brain loss when it comes to a stroke. This becomes even more important in young patients and the acronym BE FAST serves as an indication to rapidly detect a stroke:

Balance: Loss of balance
Eye: Loss of vision in one or both eyes
Face drooping: Check if one side of the face is drooping
Arm weakness: Check if one of the arms is weak or numb
Speech disability: Has your speech become slurred? Are you unable to speak or understand others?
Time to call emergency: Call the emergency services and try to get emergency care at the nearest stroke-ready centre as soon as possible.

How to prevent a stroke in the young?

A youngster with a stroke has a higher chance of recovery from it when compared to an older patient with a stroke due to better brain plasticity, which is the brain’s ability to adjust and learn new skills. However, the old dictum of prevention is better than cure still holds true when it comes to a stroke. The most important aspect of managing a stroke in the young is to identify, treat and address the triggers. Around 80 per cent of all strokes are preventable through a healthier diet and lifestyle choices. Keeping yourself active and doing moderate exercises, avoiding junk food, smoking, excessive alcohol, and drugs as well as keeping track of your blood pressure, cholesterol and overall body health are some small choices that can ensure a healthier life for yourself so that you stay away from the risk of stroke or heart attack.

(The author is a senior neurologist based in Bengaluru.)