"The groundwork of all happiness is health." - Leigh Hunt

What young people should learn about stroke risks

July 17, 2023 – Alex McKeown, 33, holds a demanding and stressful job within the investment industry in Chicago, where he negotiates and closes deals for major retail corporations.

“Overall, I would say my health is pretty good,” he said. “I've never had any major surgery, I'm not overweight, I eat pretty well and I work out at the gym.”

But during a workout at his gym, all the pieces modified.

“I woke up tired and probably wouldn't have gone to the gym if I didn't want to pay the $25 fee for a missed class,” he said.

After just the primary jiffy of his training, he began to feel dizzy.

“The room was heated and I was sweating, so I thought I was just dehydrated and needed to drink something,” he said. But he soon lost his balance and realized he had to sit down on the ground.

The fitness instructor offered him water and orange juice. When he reached for the juice together with his left hand, he saw that it was weak. He began sipping the juice and considered one of the staff noticed that his condition didn't appear to be improving.

They called 911, and when paramedics arrived, McKeown lost control of his left arm and leg and was unable to get up on his own. He was taken to Northwestern Hospital, where he was diagnosed with a stroke.

Strokes in young people

We often associate strokes with older people. But strokes can occur to anyone – even in the event that they occur much less often in younger people, says Dr. Ali Shaibani, chief of the division of neurointerventional radiology and professor of radiology at Northwestern Medicine in Chicago.

Shaibani, who treated McKeown, said it was unclear what actually caused his stroke. Shaibani initially suspected what's called a dissection, a tear in a single layer of a blood vessel, but “that turned out to be wrong.” This variety of injury is essentially the most common explanation for strokes in young people.

Some people even have heart problems. McKeown had a bicuspid aortic valve – a heart valve with 2 as an alternative of three valve leaflets – and a Aortic aneurysman enlargement or “bulge” within the aorta, the artery that carries oxygen-rich blood from the guts to the remaining of the body.

Shaibani doesn't know if these problems caused McKeown's stroke, but he knew the stroke needed to be treated as soon as possible.

“When you have a stroke, you lose about 1.9 million brain cells per minute, so we acted very quickly to remove a large blood clot that was blocking the artery leading to the right side of his brain,” he said.

McKeown was treated with TNK, a drug often used as a “blood clot dissolver,” after which put under anesthesia in order that he could Thrombectomya minimally invasive procedure that removes the blood clot and quickly restores blood flow.

The role of hypertension

According to a brand new study, hypertension is one other common explanation for strokes in younger people.

A team of investigators in Israel analyzed the medical records of nearly two million adolescents (aged 16 to 19) who were medically examined before starting their military service.

Over the years, 1,474 strokes occurred, occurring at a mean age of 43 years (range 38–47 years).

People with a history of hypertension of their youth were twice as more likely to have a stroke as people without hypertension of their youth, even after accounting for other risk aspects equivalent to BMI of their youth and diabetes of their maturity, said lead study creator Gilad Twig, MD, PhD, of Sheba Medical Center in Israel.

He and his colleagues conducted the study because they believed that the role of adolescent hypertension as a risk factor for stroke in young people was “not sufficiently understood,” despite an “increasing prevalence” of early stroke in lots of Western countries.

“The need for screening for hypertension in adolescents is clear, and we believe that additional data on the consequences of this condition can support the belief in favor of such screening,” Twig said.

His team recently published a study showing that being obese or obese during adolescence also can increase the danger of stroke in younger adults, “suggesting that it may be beneficial to address risk factors as early as adolescence.”

According to Twig, other risk aspects for stroke at a young age are much like risk aspects in old age, equivalent to smoking and diabetes.

McKeown said he had never been officially diagnosed with hypertension before his stroke, but he now takes blood pressure medication. And he can also be affected by excessive blood clotting. He takes blood thinners for that, he said. He is scheduled to undergo a more comprehensive evaluation with a hematologist, a physician who studies blood and blood disorders.

Do not ignore the signs

McKeown admits he probably would have ignored his symptoms. “I would have told myself I just have to hang on, but I was surrounded by women at the gym — especially the fitness instructor and another staff member — and I'm so grateful that they took my symptoms seriously and called 911,” he said. “Without them, I probably would have just tried to go home to sleep it off, and I probably wouldn't be able to walk or talk right now.”

No matter how old you're, never ignore symptoms. “If you ever find yourself in a situation where you're wondering if you need medical attention, call 911,” he said. “Even if there's only a 5% or 10% chance that it's something serious, you have to bite the bullet and call. You'll be much happier to be alive.”

Shaibani agreed. “Fifteen years ago, many older people ignored the signs and symptoms of a stroke,” he said. “They didn't realize that if you don't use your arm or leg properly, if you slur your speech or have a droopy mouth, you shouldn't ignore it, and that you shouldn't hope that if you take a nap it will go away.”

Younger people is probably not aware because strokes are less common on this age group. any “It is not normal for this age group to have problems using the arms or legs, to have 'funny' sounding speech, to have a drooping mouth or to have problems with vision,” he said.

An excellent tool for remembering stroke symptoms is BEFAST:

  • BBalance: (difficulty walking, dizziness)
  • Eyes (e.g. blurred vision)
  • FAce (one side is drooping or it's difficult to smile)
  • ARMS (one arm is numb or difficult to lift)
  • SSpeech (speech seems unclear, obscure)
  • TTime (if any of those symptoms occur, it's time to call 911)

“My recovery was miraculous because I got to the hospital so quickly,” McKeown said. Time is of the essence with a stroke, and “I was in surgery within maybe an hour and a half of my symptoms first appearing, which is pretty quick.”

He reports that he “continued to feel fine later in the day. I passed a swallowing test in the afternoon, could speak well, and had essentially regained my strength.” He was discharged from the hospital six days after his stroke.

Shaibani identified that many young people don't go to the doctor after completing their pediatrician experience and should not know in the event that they have conditions equivalent to hypertension or high cholesterol. It is significant to see a primary care doctor and have regular check-ups.

McKeown still has some “minimal residual symptoms,” equivalent to trouble remembering vocabulary and a few high quality motor problems in considered one of his hands and legs, but he describes himself as “probably 98% or even 99% fit, so pretty close to who I was before the stroke.” He doesn't do high-intensity exercise, but he enjoys long, “leisurely” bike rides and staying lively. And he has surgery planned on his bicuspid valve and aneurysm.