A Study of Clinical Profile and Etiological Factors of Stroke in Age Group 18-60 Years: A Study from Tertiary Care Centre in India

Abstract Background and Objective: Stroke in adults aged 18-60 years presents unique clinical and etiological profiles. This study aims to examine the clinical presentations and identify various etiological factors contributing to stroke in this age group. Methodology: A prospective observational study was conducted in the Department of General Medicine, Balrampur Hospital, Lucknow, from September 2019 to December 2020. A total of 144 patients, aged 18-60 years with a first-ever stroke (ischemic, haemorrhagic, or cerebral venous thrombosis), were included. Stroke subtypes in ischemic cases were classified according to TOAST criteria. Detailed clinical evaluations, including history, examination, and relevant investigations (basic and specific, such as vasculitis and prothrombotic workups), were performed. Stroke outcomes were assessed using the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS). Data analysis was conducted with SPSS 15.0, with significance set at p < 0.05. Results: Among the 144 cases, 68.7% were ischemic, 13.2% haemorrhagic, and 18.1% cerebral venous thrombosis (CVT). Large-artery atherosclerosis was the predominant ischemic subtype (47.5%), followed by small-vessel occlusion (27.3%). Ischemic strokes were most frequently associated with hypertension, dyslipidemia, and alcohol use, while haemorrhagic strokes were linked with hypertension and low hemoglobin levels. CVT was more prevalent in younger patients, especially females, with hyperhomocysteinemia and protein S deficiency being common findings. Migraine was a notable risk factor in a subset of ischemic strokes. Haemorrhagic strokes predominantly presented as lobar bleeds, with females affected disproportionately. Patients with CVT had the best functional outcomes, with a high rate of recovery across stroke types. Conclusion: This study highlights ischemic strokes as the most common type among young adults, followed by haemorrhagic strokes and CVT. Key risk factors include hypertension, dyslipidemia, alcohol consumption, and prothrombotic states. The findings underscore the need for targeted interventions addressing lifestyle-related risks and coagulation abnormalities in young adults to improve stroke prevention and outcomes.