Stroke in young Nigerian adults

Stroke in adults under the age of 45 results in a greater loss of potential years of life than for other adults. This premature loss of life is associated with a high social and economic burden. Few data are available regarding stroke among young Nigerian adults in the Niger Delta Basin. This study sought to determine the incidence, risk factors, stroke subtypes and case fatality of stroke among young Nigerian adults. The medical records of all 18- to 45-year-old patients admitted with stroke in the medical wards of the University of Port Harcourt Teaching Hospital (UPTH) from January 2003 to December 2008 were retrospectively reviewed. Of the 611 patients admitted with stroke, 54 (8.8%) were aged 18-45 years. There were 26 males and 28 females. Hypertension was responsible for 42 (77.8%) stroke cases. Other important risk factors were excessive alcohol intake (27.8%), heart disease (13%), diabetes mellitus (11.1%), cigarette smoking (11.1%) and HIV infection (7.4%). The total case fatality was 29.6% with intracerebral hemorrhage (ICH) having higher case fatality of 69.2% than cerebral infarction (CI) with a case fatality of 16.7%. Among the young Nigerian adults who presented with stroke, 53.7% survived. The authors conclude from the above information that the incidence of stroke in young patients at UPTH is low. Hypertension is the most important risk factor of stroke; however, other less common but important risk factors in the young adults are cigarette smoking, diabetes mellitus and HIV. Efforts should be made to reduce the impact of stroke in this age group by focusing on these risk factors, which are either preventable or modifiable.