Profil épidémiologique des Accidents Ischémiques Cérébraux du sujet jeune dans la région de Tlemcen

Abstract

Introduction Ischemic accidents in young patients are a real diagnostic challenge. They differ from those of the elderly by their etiologies .Despite an exhaustive assessment a high proportion remains of unknown causes. These are the reasons, which make our study interesting. Patients and Methods This study aims to determine the etiological and evolutionary characteristics of ischemic stroke in young patients in the region of Tlemcen according to TOAST classification, to study the clinical, epidemiological profile, and identify risk factors. This study is prospective, longitudinal and descriptive (January 2012-June 2014) .168 patients were included 15-45 years with ischemic stroke .The etiological assessment was managed according to the recommendations of the French society of neurovascular Results The parameters studied revealed a standardized incidence of 5.70 per 100,000 Hab, average age 38, 2, a sex ratio at 0.73, entry NIHSS 11 ± 3.8. The major risk factor is hypertension 33.7%, the overall average number of risk factors in our series is 1.23 ± 1.08 .As far as etiology is concerned and according to TOAST classification, crypto gene causes are on the first position (31.5%), followed by specific causes (24.4%) whose dissections are the most represented i.e. (6.5%) .The embolic heart diseasesare on the 3rd rank (20.8%) the most represented of which is the atrial fibrillation on rheumatic valve disease. The atherosclerotic causes accounted for 15.5%, from which the majority is carotid disease (7.1%). The incomplete injury is 7.7%. On the evolutionary level, mortality was 5.4%, the average mRs to 01 year is 1.78. Conclusion The results of this study confirm the need for preventive measures, by detecting the modifiable risk factors of ischemic stroke in the young subject, and early medical care of these patients in a neurovascular unit to enable the confirmation of the etiological diagnosis. Keywords: ischemic, Stroke, young patient, etiologies, TOAST, prevention, Tlemcen.