Title : Epidemiology of cerebral infarction in young adults: Study retrospective at the Annaba CHU, Algeria
Abstract:
Introduction: Cerebral infarctions (CI) in young people represent a pathology whose incidence is increasing worldwide. The particularity of this young population lies in the diversity of risk factors, as well as in the etiologies incriminated. The main objective of our study was to describe the epidemiological, etiological and evolutionary aspects of cases of cerebral infarction in young adults at the Annaba University Hospital, Algeria.
Methods: Our study is retrospective and descriptive. It covers a period of four years from January 1, 2020 to December 31, 2023. It was carried out in the neurology department, including outpatient consultations and other services at the Annaba University Hospital, Algeria. The inclusion criteria were confirmation of cerebral ischemia by neuroimaging and an age of onset between 16 and 55 years. The etiologies of HF in our patients were determined according to the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification.
Results: The study involved 180 patients, averaging 42.7 years of age (± 9.5) and a male-to-female ratio of 1.2. Hypertension was the primary risk factor, affecting 40.6% of participants, followed by patent foramen ovale in 18.9%. According to the TOAST classification, the most frequent causes were undetermined (41.1%), followed by embolic heart disease (26.7%).COVID-19 infection was the leading cause at 24.4%, followed by homozygous sickle cell disease at 19.5%. Atherosclerosis accounted for 7.8%, and small vessel occlusion for 1.7%. Sequelae occurred in 63% of patients, primarily spastic or non-spastic hemiparesis. The overall mortality rate was 8.3%. Our findings align with existing literature, with many cases having an undetermined origin, underscoring cryptogenic causes. A notable aspect of our study is its timing during the COVID-19 pandemic, which impacted the identified causes that vary significantly across studies.
Conclusion: Cerebral infarction in young individuals poses a diagnostic challenge. Our study emphasizes the need for comprehensive research into risk factors and thorough etiological assessments to develop effective therapeutic strategies for recurrence prevention.
