Stroke Incidence Increasing Among Children And Young Adults in USA

A large study has revealed that the rate of stroke among children, adolescents and young adults in the USA has been increasing at an alarming rate. The rate at which ischemic stroke patients are being hospitalized has also increased considerably, the authors reported in Annals of Neurology.

    A Stroke occur when  a ruptured blood vessel or blood clot interrupts blood flow to a part of the brain. If brain cells do not receive their supply of blood oxygen and glucose they die, leading to brain damage. The patient may subsequently have problems with memory, movement, speech, and could even die.

Blood is carried to the brain via a complex network of arteries and vessels. A stroke occurs when one of these arteries becomes blocked or an artery ruptures

 

There are two main types of stroke:

*First Type Is Ischemic stroke:

An ischemic stroke occurs when an artery in the brain becomes blocked.

What is it? Ischemic stroke occurs when an artery to the brain is blocked. The brain depends on its arteries to bring fresh blood from the heart and lungs. The blood carries oxygen and nutrients to the brain, and takes away carbon dioxide and cellular waste. If an artery is blocked, the brain cells (neurons) cannot make enough energy and will eventaully stop working. If the artery remains blocked for more than a few minutes, the brain cells may die. This is why immediate medical treatment is absolutely critical. 

   What causes it? Ischemic stroke can be caused by several different kinds of diseases. The most common problem is narrowing of the arteries in the neck or head. This is most often caused atherosclerosis, or gradual cholesterol deposition. If the arteries become too narrow, blood cells may collect and form blood clots. These blood clots can block the artery where they are formed (thrombosis), or can dislodge and become trapped in arteries closer to the brain (embolism). Another cause of stroke is blood clots in the heart, which can occur as a result of irregular heartbeat (for example, atrial fibrillation), heart attack, or abnormalities of the heart valves. While these are the most common causes of ischemic stroke, there are many other possible causes. Examples include use of street drugs, traumatic injury to the 
blood vessels of the neck, or disorders of blood clotting.

*Second Type Is Hemorrhagic stroke:
     It results from a weakened vessel that ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding brain tissue. The two types of hemorrhagic strokes are intracerebral hemorrhage or subarachnoid hemorrhage.
Hemorrhagic stroke occurs when a weakened blood vessel ruptures. Two types of weakened blood vessels usually cause hemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs) 

 A ruptured blood vessel will leak blood into the brain, eventually causing the brain to compress due to the added amount of fluid.

In this study, researchers found that over the period 1995-1996 to 2007-2008:
*Ischemic stroke incidence rose 50% among males aged 35 to 44 years
*Ischemic stroke incidence rose 46% among males aged 15 to 34.
*Ischemic stroke incidence rose 51% among boys aged 5 to 14.

In 1996, 3.1 per 10,000 hospitalizations for boys were for ischemic stroke, compared to 4.7 in 2008.
*Among females aged 35 to 44, ischemic stroke incidence rose 29%
*Among females aged 15 to 34, ischemic stroke incidence rose 23%
8For girls aged 5 to 14, ischemic stroke incidence increase by just under 3%

 
Mary G. George, MD, MSPH, and team from the CDC said:
"The increase in the stroke hospitalization rate from 1995 to 2008 was 30% to 37% higher" among those aged 15-44. In the young adults and adolescents, we were surprised to see that large of an increase. Seeing this in a young population really underscores the need for adopting and maintaining healthy lifestyles from the time they are very young."
 In this study, the investigators also looked at the traditional stroke risk factors.

Lee Schwamm, MD., vice chair of neurology at Massachusetts General Hospital and professor of neurology at Harvard Medical School said:

"The increasing incidence of risk factors in
young patients is very concerning."


Schwamm was not involved in the research but reviewed the findings.

The increase could be partly due it more advanced medical technology, George said. More accurate current imaging technology can probably identify a greater number of strokes among younger patients.

However, such risk factors as drug and alcohol abuse can be associated with strokes in a much briefer time frame

child suffers from stroke

George said:

"We found significant increases in high blood pressure, lipid [cholesterol] disorders, diabetes, tobacco use, and obesity . . . . things we consider traditional risk factors." One in every three ischemic stroke patients aged 15-34 had three stroke factors, while half of 35-44 year olds with ischemic stroke had hypertension (high blood pressure). Approximately one in every for 35 to 44 year olds with ischemic stroke had diabetes.

The researchers also found that tobacco use, raised cholesterol and obesity were common problems among patients with ischemic stroke.


The following risk factors are said to be linked to stroke risk:
*A family history
*Having had a previous stroke
*Having had a TIA (transient ischemic attack)
*African Americans and those of Hispanic or Asian/Pacific Island descent have a higher risk of stroke
*Birth control pills
*Some other hormone therapies
*Cardiovascular disease
*Cocaine usage
*Diabetes
*Heavy alcohol consumption
*Hypertension
*High cholesterol
*High amino acid levels in the blood (hormocysteine) 
*Obesity/overweight
*Smoking
*Being over 55 years of age