Ischemic and Hemorrhagic Stroke in Young Adults: Etiological Considerations, Risk Factors, and Management Strategies

Cerebrovascular events in young adults constitute a significant and often underestimated cause of long-term disability and mortality. While ischemic stroke (IS) remains the predominant subtype in this population, hemorrhagic stroke (HS) also represents a considerable burden. The etiological spectrum in younger individuals differs markedly from that in the elderly, encompassing non-traditional risk factors such as arterial dissection, prothrombotic states, cardiac embolism due to structural anomalies (e.g., patent foramen ovale), vasculitis, and substance abuse. Genetic predisposition and autoimmune conditions further complicate the diagnostic and therapeutic landscape. This review provides an in-depth analysis of the pathophysiological mechanisms underlying stroke in young adults, highlighting the distinct clinical presentations, diagnostic modalities, and therapeutic options. The role of advanced neuroimaging, thrombophilia screening, and cardiac workup is emphasized in optimizing diagnostic accuracy. Additionally, we discuss the implications of early intervention strategies, including thrombolysis and endovascular therapy, alongside secondary prevention approaches tailored to this demographic. A comprehensive understanding of the unique aspects of stroke in young adults is imperative for improving clinical outcomes and reducing long-term disability in this patient population.