Objectives:Stroke is a major
cause of morbidity and mortality worldwide. It is increasingly common from the
sixth decade, but is particularly tragic when it occurs in young adults. There
are limited studies of stroke in young adults in Nigeria. It is against this background
that we embarked on this prospective hospital based study to determine the
epidemiology, pattern and case fatality rate of stroke in young adults in
Abakaliki Southeastern part of Nigeria. Patients and Method: The stroke
patients between the ages of 18- 50years admitted to the medical wards of a tertiary
health centre at Abakaliki Nigeria from 1st August 2012 to 30th April 2019 were
consecutively recruited. They were followed up till discharge. Relevant data
like biodata, and clinical features of the patients were extracted and
analyzed. Results:A total of
983 (males—511, females—472) stroke cases were
seen with 197 between 18- 50years. One hundred and fifty two (77%) did neuroimaging (mean age—40.7years). Eighty-eight
(57.9%) had Cerebral infarct (males—42, females—46) while 64 (42.1%) had Hemorrhagic stroke
(males—35, females—29). For those that had hemorrhagic stroke,
11 (17.2%) were Subarachnoid hemorrhage (SAH) while 52 (82.8%) were
Intracerebral hemorrhage (ICH). The identified risk factors range from
hypertension, DM, dyslipidemia, alcoholism, cigarette smoking, HIV infection
and chronic use of coffee drinks. Sixteen patients died during the admission
with case fatality rate of 10.5%. Conclusion:Stroke is actually prevalent in young adults as 1 in every 5
stroke patients seen was a young adult. In addition to the traditional risk
factors, HIV/AIDS and chronic use of coffee drinks were also
References
[1]
Sacco, R.L., Kasner, S.E., Broderick, J.P., Caplan, L.R., Culebras, A., Elkind, M.S., George, M.G., et al. (2013) An Updated Definition of Stroke for the 21st Century. Stroke, 44, 2064-2089. https://doi.org/10.1161/STR.0b013e318296aeca
[2]
Schulte, B.P. (1989) Neuroepidemiology of Cerebrovascular Disease: An Overview in Advances in Neurology. Proceedings of the 14th World Congress of Neurology, New Delhi, 3.
[3]
Agyemang, C., Addo, J., Bhopal, R., Aikins Ade, G. and Stronks, K. (2009) Cardiovascular Disease, Diabetes and Established Risk Factors among Populations of Sub-Saharan African Descent in Europe: A Literature Review. Global Health, 5, 7.
https://doi.org/10.1186/1744-8603-5-7
[4]
Martin, P.J., Enevoldson, T.P. and Humphrey, P.R. (1997) Causes of Ischaemic Stroke in the Young. Postgraduate Medical Journal, 73, 8-16.
https://doi.org/10.1136/pgmj.73.855.8
[5]
Owolabi, L.F. and Ibrahim, A. (2012) Stroke in Young Adults: A Prospective Study from Northwestern Nigeria. ISRN Neurology, 2012, Article ID: 468706.
https://doi.org/10.5402/2012/468706
[6]
Bǎsic Kes, V., Zavoreo, I. and Demarin, V. (2012) Etiology and Diagnostic Work-Up in Young Stroke Patients. Periodicum Biologorum, 114, 355-359.
[7]
Nedeltchev, K., der Maur, T.A. and Georgiadis, D. (2005) Ischaemic Stroke in Young Adults: Predictors of Outcome and Recurrence. Journal of Neurology, Neurosurgery, and Psychiatry, 76, 191-195. https://doi.org/10.1136/jnnp.2004.040543
[8]
Varona, J.F., Guerra, J.M., Bermejo, F., Molina, J.A. and de la Camara, G. (2007) Causes of Ischemic Stroke in Young Adults, and Evolution of the Etiological Diagnosis over the Long Term. European Neurology, 57, 212-218.
https://doi.org/10.1159/000099161
[9]
George, M.G., Tong, X., Kuklina, E.V. and Labarthe, D.R. (2011) Trends in Stroke Hospitalizations and Associated Risk Factors among Children and Young Adults, 1995-2008. Annals of Neurology, 70, 713-721. https://doi.org/10.1002/ana.22539
[10]
Eze, C.O., Agu, C.E., Kalu, U.A., Maduanusi, C.A., Nwali, S.T. and Igwenyi, C. (2013) The Pattern and Presentation of Stroke in Federal Teaching Hospital Abakaliki (FETHA) South-East Nigeria. Journal of Biology, Agriculture and Healthcare, 3, 141.
[11]
Sarfo, F.S., Ovbiagele, B., Gebregziabher, M., Wahab, K., Akinyemi, R., Akpalu, A., Akpa, O., Obiako, R., Owolabi, L., Jenkins, C. and Owolabi, M. (2018) Stroke among Young West Africans: Evidence from the SIREN (Stroke Investigative Research and Educational Network) Large Multisite Case-Control Study. Stroke, 49, 1116-1122.
https://doi.org/10.1161/STROKEAHA.118.020783
[12]
How Long Does Alcohol Stay in Your Blood? NHS Choices.
[13]
Onwuchekwa, A.C., Onwuchekwa, R.C. and Asekomeh, E.G. (2009) Stroke in Young Nigerian Adults. Journal of Vascular Nursing, 27, 98-102.
https://doi.org/10.1016/j.jvn.2009.08.001
[14]
Odaman, O.M. and Ibiezugbe, M.I. (2014) Health Seeking Behavior among the Elderly in Edo Central Nigeria. International Review of Social Sciences and Humanities, 7, 201-210.
[15]
Oyinloye, O., Nzeh, D., Adesiyun, O., Ibrahim, M., Akande, H. and Sanya, E. (2015) Neuroimaging of Young Adults with Stroke in Ilorin Nigeria. Annals of African Medicine, 14, 82-88. https://doi.org/10.4103/1596-3519.149897
[16]
Rinkel, G.J., Djibuti, M., Algra, A. and Gijn, J. (1998) Prevalence and Risk of Rupture of Intracranial Aneurysms—A Systematic Review. Stroke, 29, 251-256.
https://doi.org/10.1161/01.STR.29.1.251
[17]
Nwosu, C.M., Nwabueze, A.C. and Ikeh, V.O. (1992) Stroke at the Prime of Life: A Study of Nigerian Africans between the Ages of 16 and 45 Years. East African Medical Journal, 69, 384-390.
[18]
Planning Committee for a Workshop on Potential Health Hazards Associated with Consumption of Caffeine in Food and Dietary Supplements, Food and Nutrition Board; Board on Health Sciences Policy, Institute of Medicine (2014) Caffeine in Food and Dietary Supplements: Examining Safety. National Academies Press, Washington DC.
[19]
Eze, C.O. and Kalu, U.A. (2014) The Prognosis of Acute Stroke in a Tertiary Health Centre in South-East Nigeria. Nigerian Journal of Medicine, 23, 306-310.
