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Relative frequencies of ischemic-stroke causes differ between younger and older adults. In this retrospective analysis from a tertiary stroke unit in France, researchers reported causes of acute ischemic strokes in 318 consecutive younger patients (age range, 16–54). Nearly all patients underwent brain magnetic resonance imaging or computed tomography (with angiography of cerebral and cervical arteries); if these studies failed to reveal a definitive cause, transesophageal echocardiography was performed. Other studies (e.g., continuous electrocardiography monitoring, tests for thrombophilias) were performed selectively.
Definite causes were identified in nearly half of cases — 15% atherothrombosis, 8% small-vessel disease, 8% cardioembolism …