Stroke in young adults: etiopathogenetic mechanisms (bibliosemantic analysis). A clinical case from personal practice

The literature review demonstrates that ischemic stroke in young adults accounts for 10–15 % in all age groups. Among the etiological risk factors, the most significant are hypertension, vascular developmental anomalies, and genetically determined factors — particularly in cases of heart pathology (rhythm and conduction disorders, patent foramen ovale) and kidney di-seases. For example, the annual increase in ischemic stroke among young adults is attributed to extracranial artery dissection, with a 2.4-fold rise per 100,000 population. An important role is played by antiphospholipid syndrome, cardiac embolism resulting from thrombotic lesions of the heart valves, acute myocardial infarction, ventricular or atrial septal defects, vasculitis caused by various infectious and systemic diseases, moyamoya disease, mitochondrial encephalopathies, hyperhomocysteinemia, and congenital pathology of the major arteries of the head and neck (elongation, kinking, looping). Identified risk factors include the presence of migraine with aura, the use of estrogen-containing oral contraceptives, smoking, excessive alcohol consumption, and drug use. The main prothrombotic conditions associated with the development of ischemic stroke in young adults are described, including pregnancy and the postpartum period, a history of COVID-19, and cancer. Thus, the multifactorial nature of stroke development in young adults has been identified. The review highlights diagnostic approaches using instrumental and laboratory investigations. A clinical case of atherothrombotic ischemic stroke in a young patient from personal practice is described.