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Researchers conducted a clinical review of the causes of stroke in 273 patients aged 16 to 49 years who had been evaluated at one medical center in Italy from 1994 through 2001. Apparently no standard protocol for diagnosis was used, so it is unclear how extensive the workup was. Nonetheless, the reported diagnostic testing (including MRI in 48% and catheter angiography in 30%) appears representative of what would likely be done in most tertiary centers in the U.S. Not all patients had stroke on imaging, and 26% of events were clinically classified as TIA.
Among patients aged 40 to 49, the most common stroke classifications were large-vessel disease and small-vessel disease, whereas in patients younger than 40, cardiac embolism was more ofte…