Cases of stroke are increasing, especially in young people… and here’s why. (Page 2 ) | May 15, 2025

Specific Causes of Stroke in Young People

For illustrative purposes only
Migraine with Aura

People who suffer from migraine with aura have double the risk of ischemic stroke. It is postulated that cortical depression induces endothelial dysfunction and facilitates platelet aggregation (Bukharie et al., 2023).

The risk increases when oral contraceptives or smoking coexist; recognizing this association allows for early intervention with preventive therapies and health education.

Pregnancy and Contraceptives

Pregnancy increases blood volume and coagulability, while the postpartum period is associated with hemodynamic fluctuations. Both periods increase the likelihood of stroke threefold compared to non-pregnant women.

Combined estrogen-progestin contraceptives may double the risk, especially in the presence of migraine with aura or thrombophilia, reasons that underscore the demand for individualized counseling.

Heart Disease and Patent Foramen Ovale

Up to one-third of cryptogenic strokes in patients under 55 years of age are associated with patent foramen ovale (PFO). The paradoxical passage of emboli from the venous circulation explains unexpected arterial occlusions in brains without atherosclerosis.

Echocardiographic detection and percutaneous closure of PFOs have been shown to reduce recurrences, constituting an example of precision medicine in vascular neurology.

Arterial Dissection and Cervical Trauma

High-intensity exercise, chiropractic manipulations, or minor accidents can tear the intima of carotid and vertebral arteries. Dissection is the leading cause of arterial stroke in patients under 45 years of age.

Early diagnosis by CT angiography or MRI and early anticoagulation are crucial to prevent extensive infarcts of the brainstem or carotid territory.

Autoimmune Diseases and Coagulation Disorders

Systemic lupus erythematosus, antiphospholipid syndrome, and sickle cell anemia increase platelet aggregation and thrombus formation. Young people with these conditions require close neurological monitoring.

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The Role of the Environment and Social Inequalities
Education and Socioeconomic Status

The CDC study found that people without a high school education experienced the highest percentage increase in strokes. Lack of education limits access to preventive information and quality healthcare resources.

Pollution and Thermal Stress

Prolonged exposure to PM2.5 particles is associated with systemic endothelial dysfunction. The GBD2021 study found a 72% increase in the burden attributable to extreme ambient temperatures, a phenomenon that is particularly severe in dense urban environments.

Access to Care and Diagnostic Delay

In rural populations, young people take longer to recognize symptoms and reach centers with stroke units. The therapeutic window is lost, and the after-effects worsen, perpetuating the cycle of disability and poverty.

Multidimensional consequences of stroke in young people

Surviving a stroke before the age of 40 means living with motor deficits, aphasia, or epilepsy for productive decades. The psychological impact includes depression, anxiety, and alterations in work identity.

The economic cost includes prolonged rehabilitation, loss of family income, and increased public healthcare spending. Each disability-adjusted life year in a young person generates a much greater social burden than at older ages.

Families assume long-term caregiving roles, with emotional and financial repercussions that extend to children and partners, reinforcing the urgency of preventive measures.

What can we do to prevent it?

Incorporating routine blood pressure and lipid profile measurements in late pediatric visits detects risk factors before the age of 30 and allows for early pharmacological interventions.

Promoting plant-based diets, daily physical activity, and smoke-free environments reduces systemic inflammation and improves metabolism; schools and workplaces are key settings.

Mobile brain health apps monitor blood pressure, heart rate, and medication reminders, bringing monitoring closer to digitalized populations with little healthcare contact.

In conclusion
The increase in strokes in young people is an indicator that the epidemiological transition is progressing faster than expected and that classic risk factors are manifesting at increasingly earlier ages.

Understanding the multiple causes of stroke in young people—from hypertension and obesity to migraine with aura or arterial dissection—allows for the design of targeted and personalized prevention strategies.

Acting now with evidence-based policies, health education, and equal access to health care is the best guarantee to reverse the trend and protect new generations from avoidable disability.

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