Heart defects or genetic deficiencies are silent causes of stroke in people 25-45 years old but receive little attention.
Since the Lunar New Year until now, strokes in young people – usually defined as the group aged 45 and under, at Military Hospital 175 (HCMC) have increased by more than 30%. Some days, more than half of the stroke patients hospitalized are under 45 years old.
Similarly, at the Stroke Center, Bach Mai Hospital (Hanoi) also received 6 stroke patients under the age of 45 in one night in early March, the most in recent years.
“Stroke in young people is just the tip of the iceberg. The underlying cause of stroke is a key factor that needs to be determined during the treatment process,” said Dr. Hoang Tien Trong Nghia, Head of the Department of Internal Medicine. Neurology, Military Hospital 175, said.
Recently, the hospital admitted a 37-year-old woman who was admitted because of sudden dizziness and lightheadedness. Due to timely admission to the hospital, the patient is eligible to use fibrinolytic drugs.
After injection, the patient’s symptoms improved, but with abnormalities on previous imaging diagnostics, doctors suspected there was an underlying cause of the stroke at a relatively young age. Patients are examined and screened in depth. With results suggesting the existence of a right-left heart defect on the transcranial ultrasound survey, the neurologist consulted with an interventional cardiologist and performed additional imaging to help locate the existing defect. at the foramen ovale in the heart.
Doctor 1 Pham Thi Thu Ngan, Department of Neurology, said that in healthy people, the foramen ovale will close on its own after birth. However, about 25-30% of the population will have a foramen ovale that persists into adulthood. Foramen ovale alters the normal flow of blood in the heart through the compartments at risk of forming clots, following arteries to the brain and blocking blood supply branches to the brain, causing stroke and ischemic stroke.
“Existence of patent foramen ovale is a common cause of stroke in young people but was previously little noticed,” the doctor said. The reason is often that stroke symptoms in young people can develop very discreetly, causing them not to go to a specialized hospital for timely screening.
In this case, cerebral infarction was determined to be due to thrombosis formed from a malformation that existed for a foramen ovale. Interventional Cardiologists closed the foramen ovale, completely resolving the cause of cerebral infarction. After two weeks of rehabilitation exercises, speech therapy, and transcranial magnetic stimulation, the patient fully recovered and returned to normal work.
Patients are examined and treated for post-stroke pain with a transcranial magnetic field machine at the Clinical Neurophysiology Unit, Military Hospital 175. Photo: Chinh Tran
Or the case of a male patient, 32 years old, smokes about 2 cigarettes a day, admitted to the department because of right coronary cerebral infarction. Taking the medical history, the doctor was interested in the fact that the patient’s two sisters had a myocardial infarction before the age of 40 and the mother had a cerebral infarction at the age of 43.
According to doctor Phan Xuan Uy Hung, this suggests that there is a genetic factor causing the disease. In-depth tests were performed, detecting that the patient’s protein C rate was only 30% compared to normal people. This deficiency often forms blood clots in the blood vessels, leading to cerebral infarction and myocardial infarction.
Immediately afterward, the patient’s mother and sister agreed to be tested, and the result of protein C was only 23-30%. Thanks to careful examinations, the patient’s family is treated and managed by doctors from the Department of Neurology, helping to reduce the risk of recurrent stroke.
Currently, deaths from cardiovascular disease rank first globally. However, in about 40% of countries, the cause of death from stroke ranks first, higher than cardiovascular disease, including Vietnam and China. Our country is among the countries with the highest risk of stroke in the world.
Therefore, doctors believe that screening and detecting the cause of stroke at specialized medical facilities is a key issue in the management and prevention of stroke at any age. Everyone needs regular health check-ups. If the main culprits causing stroke in general such as hypertension, diabetes, atrial fibrillation, etc. are detected, long-term control medication is needed. Do not arbitrarily stop taking medicine when your health feels good or buy medicine according to the old prescription. Avoid risk factors for stroke by stopping smoking, limiting alcohol, controlling weight, proper nutrition, and regular physical activity.
Go to the emergency room immediately if you have any of the following symptoms of numbness or weakness in the face, arms or legs. Note when symptoms occur on one side of the body, mouth distortion, sudden inability to speak or difficulty speaking, blurred vision, headache, dizziness, or loss of balance.