Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 8 Issue 8

Epidemiological, Clinical, Etiological and Therapeutic Aspects of Stroke in Young People Under 50 Years

Fatimata Hassane Djibo1,2*, Daou Maman1,4, Ibrahim Moussa Daouda1,2, Moudassir Mahamat Ahmat1,2, Amadou Hassan Aboubacar1,2, Souleymane Brah1,4, Carlos Othon Guelngar2, Abdoul Bachir Djibo Hamani2, Amadou Bacharou1, Mahadi Moussa1 and Eric Adehossi Omar4

1Neurology Department of the National Hospital of Niamey, Nigervo
2Neurology Department of the Amirou Boubacar Diallo National Hospital, Niger
3Internal Medicine Department of the National Hospital of Niamey, Niger
4Faculty of Health Sciences of the UAM of Niamey (Niger), Niger

*Corresponding Author: Fatimata Hassane Djibo, Neurology Department of the National Hospital of Niamey, Niger.

Received: May 17, 2024; Published: July 11, 2024

Abstract

Introduction: Cerebrovascular accidents (CVAs) are a real public health problem throughout the world. They are the most common neurological condition in industrialized countries where they represent: the first cause of acquired disability in adults; the second cause of vascular dementia; the third cause of death, i.e. 9% of deaths. Strokes are more and more frequent in young people with various etiologies.

Objective: To determine the clinical etiological and therapeutic aspects of stroke in Young people.

Results: This is a prospective descriptive study on 119 cases at the NHN and the CNRD during the period from 06 June 2018 to 01 October 2019, i.e. a period of 17 months.

A predominance of women is 51.2%. Average age: 30.59 years ± 16,45. The patients had consulted a general practitioner before admission, i.e. 64.7%. The largest number of patients was hypertensive, 49,6%. 35,3% of patients had 2 risk factors (migraine and sedentary lifestyle). There is a predominance of left hemiplegia, 20,2%. The majority of patients (58,8%) received less than 24 hours of admission. The majority of patients had a Glasgow score between 11 and 15 (66,4%). We found a rate of anemia and hyperleukocytosis of 3,4% each and 1,7% of polycythemia Most of the strokes were of sickle cell origin or 26%. The most common abnormality on CT scan was hypodensity with 51,3% of cases. The Sylvian territory was the most affected with 45,4%. 53,8% of patients had taken antihypertensive drugs, 41,2% had taken platelet aggregation inhibitors, 99,2% had received physiotherapy and 7,6% had received anti-edematous therapy. The average length of hospital stay was 7-14 days or 50,4%. The majority of patients had an NIHSS score between 5-15 or 83,2%.

Conclusion: The stroke does not spare the young subject, long considered a disease of the third age. The strokes of the young subject are different from those of the elderly by their multiple etiologies, hence the relentless search for the etiology.

 Keywords: Aspects; Clinical; Stroke; Therapeutic; Niamey; Niger

 

References

  1. Sagui E. “Les accidents vasculaires cérébraux en Afrique subsaharienne”. Médecine tropicale 67 (2007): 596-600.
  2. Amarenco P. “Accidents vasculaires cérébraux Epidémiologie, étiologie, physiopathologie, diagnostic, évolution, traitement”. Rev du Prat 48 (1998): 1939-1951.
  3. Woimant F., et al. “Société Française Neuro-Vasculaire. Recommandationspour la création d’Unités neurovasculaires”. Revue Neurologique (Paris) 157 (2001): 1447-56.
  4. Leys D. “Ischemic strokes in young adults”. Rev Médecine Interne Fondée Par Société Natl Francaise Médecine Interne 9 (2003): 585-593.
  5. Adams HP., et al. “Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups”. Journal of Stroke and Cerebrovascular Diseases5 (2007): 1655-1711.
  6. Lund CJ and Donovan JC. “Blood volume during pregnancy, Significance of plasma and red cell volumes”. American Journal of Obstetrics and Gynecology 98 (1967): 393-403.
  7. Barrett JM., et al. “Pregnancy related rupture of arterial aneurysms”. Obstetrical and Gynecological Survey 37 (1982): 557Ŕ66.
  8. Strng K., et al. “Representing stroke: saving lives around World”. Lancet Neurology 6 (2007): 182-187.
  9. Hankey GJ and Warlow C. “Treatment and secondary prevention of stroke: evidence, Costes and effects on individuals and population”. Lancet (1999): 1457-1463.
  10. Awada A., et al. “Accidents vasculaires cérébraux des adultes jeunes en Arabie Saoudite, Etude de 136 cas”. Revue Neurologique (Paris) 148 (1992): 550-554.
  11. Bogousslavsky J and Regli F. “Ischemic strokes in adults younger than 30 years of age: cause and prognosis”. Archives of Neurology 44 (1987): 479Ŕ82.
  12. Ducrocq X., et al. “Accidents vasculaires cérébraux ischémiques du sujet jeune, Étude prospective de 296 patients âgés de 16 à 45 ans”. Revue Neurologique (Paris) 155 (1999): 575Ŕ82.
  13. Bardet J. “Rapport sur la prise en charge précoce des accidents vasculaires cérébraux. office parlementaire d’évaluation des politiques de sante” (2007).
  14. Murray CJ and Lopez AD. “Mortality by cause for eight region of the world: Global Burden of Disease study”. Lancet 349 (1997): 1269-1276.
  15. Macleod M and Davis SM. “Stroke”. Lancet 371 (2008): 1612-1623.
  16. Bogousslavsky J and Pierre P. “Ischemic stroke in patients under age 45”. Suisse. Depart Neurol Clin1 (1992): 113-124.
  17. Adams HP., et al. “Ischemic stroke in young adults, Experience in 329 patients enrolled in the Iowa Registry of stroke in young adults”. Archives of Neurology 52 (1995): 491Ŕ5.
  18. Ducrocq X., et al. “Accidents vasculaires cérébraux ischémiques du sujet jeune, Étude prospective de 296 patients âgés de 16 à 45 ans”. Revue Neurologique (Paris) 155 (1999): 575Ŕ82.
  19. Bogousslavsky J and Regli F. “Ischemic strokes in adults younger than 30 years of age: cause and prognosis”. Archives of Neurology 44 (1987): 479Ŕ82.
  20. Kristensen B., et al. “Epidemiology and etiology of ischemic stroke in young adults aged 18 to 44 years in northern Sweden”. Journal of Stroke and Cerebrovascular Diseases9 (1997): 1702-1709.
  21. Cowppli-Bony P., et al. “Aspects tomodensitométriques des accidents vasculaires cérébraux ischémiques à Abidjan (Côte d’Ivoire)”. Cahiers d’études et de recherches francophones/Santé 16.2 (2006): 93-96.
  22. Khan FY. “Risk factors of young ischemic stroke in Qatar”. Clinical Neurology Neurosurgery9 (2007): 770-773.
  23. Varona JF., et al. “Causes of Ischemic Stroke in Young Adults, and Evolution of the Etiological Diagnosis over the Long Term”. European Journal of Neurology 57 (2007): 212-218.
  24. Cerrato MG., et al. “Stroke in young patients: etiopathogenesis and risk factors in different age classes”. Cerebrovascular Diseases (Basel, Switzerland)2 (2004): 154-159.
  25. Rouhart F., et al. “Accidents artériels ischémiques cérébraux de l’adulte jeune”. 40 cas Revue Neurologique (Paris) 149 (1993): 547-553.
  26. Kwasa TO and Lowe W. “Stroke at Kenyatta National Hospital”. East African Medical Journal 7 (1990): 482-486.
  27. Ahmed A., et al. “Types anatomiques et facteurs de risqué des accidents vasculaires cérébraux à Madagascar”. Médecine d’Afrique Noire10 (2002): 429-435.
  28. Datie A-M., et al. “Problèmes liés à la prise en charge réeducative des hémiplégégies vasculaires à Abidjan (Côte d’Ivoire)”. African Journal of Neurological Sciences1 (2002): 15-20.
  29. PSATY BM., et al. “Au etats unis health outcomes associated with antihypertensive therapies used as first line agents a systemic review and meta-analysis”. JAMA 277 (1997): 739-745.
  30. Task force on stroke and other cerebrovascular disorders, geneva who OMS (1989): 53.
  31. OMS/WHO. Rapport sur l’etat de santé dans le monde 1995.reduire le ecarts. Geneve. OMS (1995): 118.
  32. Simon O., et al. “Les accidents ischémiques constitués de l’adulte jeune”. Sang Thrombose Vaisseaux these de medecine lille 8 (1996): 27-37.
  33. Wolleart G. l’AVC au service d’admission des urgences du CH.d’armentieres. thesemedecine. Lille (2005): 110.
  34. Bougousslavsky J. “Les accidents vasculaires cerebraux du sujet jeune”. med et hyg 48 (1990): 27550-2754.
  35. Sangaré S. Les accidents vasculaire cerebraux hypertensifs chez le sujet jeune au CHU du pont G dans le service de cardiologie A et B. These de medecine, bamako 2009-2010.
  36. Bejat Y., et al. “Trends in incidence of ischeamic stroke in young adults 1985-2011. the dijon stroke register”. Neurosurgery Psychiatry5 (2014): 509-536.
  37. Bogousslavsky J and Pierre P. “Ischemic stroke in patients under age 45”. Suisse. Depart Neurol Clin 10.1 (1992): 113-124.
  38. Awada A., et al. “Accidents vasculaires cérébraux des adultes jeunes en Arabie Saoudite, Etude de 136 cas”. Revue Neurologique (Paris) 148 (1992): 550-554.
  39. Accident vasculaire cerebral chez les sujet jeune a l’hopital militaire de l’instruction mohamed 5 de rabbat. service de neurologie. these de medecine (2009).
  40. Awada A., et al. “Accidents vasculaires cérébraux des adultes jeunes en Arabie Saoudite, Etude de 136 cas”. Revue Neurologique (Paris) 148 (1992): 550-554.
  41. Kristensen B., et al. “Epidemiology and etiology of ischemic stroke in young adults aged 18 to 44 years in northern Sweden”. Journal of Stroke and Cerebrovascular Diseases9 (1997): 1702-1709.
  42. Touré M. “Etude épidemio-clinique et évolutive des accidents vasculaires cérébraux hypertensis au CHU du Point G dans le service de Cardiologie A”. Thèse de médecine, FMPOS, Bamako (2007).
  43. Alessando C., et al. “Deuxpays deux jeunesse”. la condition juvenile en France etItalie Rennes, pur (2009).
  44. Aho K., et al. “Cerebrovascular disease in the community: results of a WHO collaborative study”. Bulletin of the World Health Organization 58 (1980): 113-130.
  45. Fleigin VL., et al. “Stroke epidemiology: a review of population–based studies of Incidence, prevalence, and case-fatality in the late 20th century”. Lancet Neurology 2 (2003): 43-53.
  46. Kim AN., et al. “Agence Régionale de l’Hospitalisation d’Ile de France. Accidents vasculaires cérébraux”. Rapport du groupe de travail AVC (2002): 215.
  47. Langhorne P., et al. “Do stroke units save lives”. Lancet 342 (1993): 295-398.
  48. Langhorne P., et al. “Formal overview of stroke unit trials”. Revue Neurologique 23 (1995): 394-398.
  49. Bardet J. “Rapport sur la prise en charge précoce des accidents vasculaires cérébraux”. office parlementaire d’évaluation des politiques de sante (2007).
  50. William A and Pulsinelli. “Maladies cérébro-vasculaires Cecil”. Traité de médicine interne. 1ère édition. Flammarion, Paris, 1997.
  51. Talabi OA-A. “Review of neurologic admissions in University College Hospital Ibadan, Nigeria”. West African Journal of Medicine 22 (2003): 150-151.
  52. Amarenco P. “Accidents vasculaires cérébraux Epidémiologie, étiologie, physiopathologie, diagnostic, évolution, traitement”. Rev du Prat ,Paris 48 (1998): 1939-1951.
  53. Adams HP., et al. “Guidelines for the early management of adults withischemic stroke: a guideline from the American Heart Association/American Stroke Association Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups”. Journal of Stroke and Cerebrovascular Diseases5 (2007): 1655-1711.
  54. Aboudelmounene N and Dosquet P. “Prise en charge initiale des accidents vasculaires cérébraux de l’adulte”. ANAES/Service des recommandations professionnelles / Septembre (2002): 20.
  55. Woimant F., et al. “Société Française Neuro-Vasculaire. Recommandations pour la création d’Unités neurovasculaires”. Revue Neurologique (Paris) 157 (2001): 1447-1456.
  56. Grimmomprez JC. “Analyse de la prise en charge des AVC dans un hopital general”. These de medecine (1997): 45.
  57. Frid AM. “Accidents vasculaire cerebraux sujet jeune tunisiemedicale”. 82 (2004): 506-511.
  58. Adams HP., et al. “Ischemic stroke in young adults, Experience in 329 patients enrolled in the Iowa Registry of stroke in young adults”. Archives of Neurology 52 (1995): 4.

Citation

Citation: Fatimata Hassane Djibo., et al. “Epidemiological, Clinical, Etiological and Therapeutic Aspects of Stroke in Young People Under 50 Years”.Acta Scientific Medical Sciences 8.8 (2024): 79-87.

Copyright

Copyright: © 2024 Fatimata Hassane Djibo., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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