Stroke in Young Adults: A Narrative Review of Clinico-Radiological Approach to Twenty Key Etiologies.
- 1Division of Neurology, University of Milan, 20133 Milan, Italy.
- 2Division of Neuroradiology, Faculty of Medical Sciences of Santa Casa de São Paulo, São Paulo 01225-010, Brazil.
- 3Division of Neurology, Faculty of Medical Sciences of Santa Casa de São Paulo, São Paulo 01225-010, Brazil.
Abstract
Background: Stroke in young adults is increasing worldwide and is associated with substantial long-term disability. Unlike stroke in older populations, young patients frequently present with uncommon etiologies that require specific diagnostic approaches and targeted secondary prevention strategies. Early recognition of these causes remains a major clinical challenge. Objective: This study aimed to provide a comprehensive review of the principal uncommon causes of stroke in young adults, emphasizing their clinical characteristics and neuroimaging findings relevant to etiological diagnosis. Methods: A narrative review was conducted focusing on cerebrovascular disorders that disproportionately affect young adults, including arterial dissections, patent foramen ovale, moyamoya disease, reversible cerebral vasoconstriction syndrome, cerebral venous thrombosis, thrombophilias, autoimmune diseases, infections, genetic disorders, malignancy, and cardiac conditions. Particular attention was given to neuroradiological patterns and imaging modalities useful for diagnosis. Results: Numerous uncommon etiologies contribute significantly to stroke in young adults and often occur in the absence of traditional vascular risk factors. Neuroimaging plays a pivotal role in diagnosis, helping identify characteristic findings such as double-lumen signs in arterial dissections, collateral vessel networks in moyamoya disease, reversible multifocal vasoconstriction in RCVS, venous filling defects in cerebral venous thrombosis, and distinctive imaging signatures associated with genetic, infectious, inflammatory, and neoplastic disorders. Recognition of these patterns can substantially improve diagnostic accuracy and guide appropriate secondary prevention. Conclusions: Stroke in young adults encompasses a broad spectrum of etiologies that differ considerably from those observed in older populations. Awareness of characteristic clinical and neuroimaging features is essential for accurate etiological investigation and implementation of effective preventive strategies.
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BibTeX
@article{vitturi2026stroke,
title = {{Stroke in Young Adults: A Narrative Review of Clinico-Radiological Approach to Twenty Key Etiologies.}},
author = {Bruno Kusznir Vitturi and Felipe Torres Pacheco and Rubens José Gagliardi},
journal = {Clinics and practice},
year = {2026},
month = sep,
doi = {10.3390/clinpract16100180},
url = {https://europepmc.org/article/MED/42930366},
note = {CC BY},
}
RIS
TY - JOUR
TI - Stroke in Young Adults: A Narrative Review of Clinico-Radiological Approach to Twenty Key Etiologies.
AU - Bruno Kusznir Vitturi
AU - Felipe Torres Pacheco
AU - Rubens José Gagliardi
PY - 2026
DA - 2026/09/29
JO - Clinics and practice
DO - 10.3390/clinpract16100180
UR - https://europepmc.org/article/MED/42930366
AB - Background: Stroke in young adults is increasing worldwide and is associated with substantial long-term disability. Unlike stroke in older populations, young patients frequently present with uncommon etiologies that require specific diagnostic approaches and targeted secondary prevention strategies. Early recognition of these causes remains a major clinical challenge. Objective: This study aimed to provide a comprehensive review of the principal uncommon causes of stroke in young adults, emphasizing their clinical characteristics and neuroimaging findings relevant to etiological diagnosis. Methods: A narrative review was conducted focusing on cerebrovascular disorders that disproportionately affect young adults, including arterial dissections, patent foramen ovale, moyamoya disease, reversible cerebral vasoconstriction syndrome, cerebral venous thrombosis, thrombophilias, autoimmune diseases, infections, genetic disorders, malignancy, and cardiac conditions. Particular attention was given to neuroradiological patterns and imaging modalities useful for diagnosis. Results: Numerous uncommon etiologies contribute significantly to stroke in young adults and often occur in the absence of traditional vascular risk factors. Neuroimaging plays a pivotal role in diagnosis, helping identify characteristic findings such as double-lumen signs in arterial dissections, collateral vessel networks in moyamoya disease, reversible multifocal vasoconstriction in RCVS, venous filling defects in cerebral venous thrombosis, and distinctive imaging signatures associated with genetic, infectious, inflammatory, and neoplastic disorders. Recognition of these patterns can substantially improve diagnostic accuracy and guide appropriate secondary prevention. Conclusions: Stroke in young adults encompasses a broad spectrum of etiologies that differ considerably from those observed in older populations. Awareness of characteristic clinical and neuroimaging features is essential for accurate etiological investigation and implementation of effective preventive strategies.
SN - 2039-7275
SN - 2039-7283
ER -