Strokes without a definitive identifiable cause account for up to 50% of juvenile strokes. In juvenile strokes, the range of causes is wider and their frequency distribution differs from that in older stroke patients, in whom the classic cardiovascular risk factors are primarily implicated.
Identifying rare causes of stroke in the 18-55 age group requires a great diagnostic effort. In a review article in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2017; 114: 527-34), Florian Schöberl and coauthors explain comprehensively the possible causes of juvenile stroke, which affect some 30 000 persons in Germany every year. Only 40% of juvenile stroke patients return to their original place of work, about a third of these patients remains permanently unfit for work. The acute treatment of juvenile arterial-ischemic stroke, however, does not differ from that of older patients: systemic thrombolysis and/or mechanical thrombectomy are the treatments of choice.