Contrary to conventional thinking, it’s not just senior citizens who suffer strokes. One-third of the estimated 780,000 Americans who have strokes each year are under age 65. Even teens, children, and infants can be susceptible.
Cedars-Sinai Medical Center, Los Angeles, may be one of the few centers in the nation offering a special support group for younger survivors of strokes—the “brain attacks” that occur when an area of the brain is deprived of oxygen after an artery becomes blocked or ruptured. Launched in September 2007, “One Stroke Ahead: Young Person’s Stroke Support Group” caters to survivors ranging in age from 18 to 55, addressing issues faced by those with interests in returning to school or work and resuming their family roles and responsibilities.
“Most people generally know what a stroke is, but unless their lives are directly affected, they rarely have an understanding of the consequences of stroke or potential outcomes," says David Palestrant, MD, director of Neuro-Critical Care and the Stroke Program at Cedars-Sinai. "The support group provides an opportunity for young stroke survivors to share their experiences and learn from one another about coping with the dramatic changes taking place in their lives,”
The support group’s facilitator, Terri Lukomski, a certified therapeutic recreation specialist (CTRS) at Cedars-Sinai’s Department of Physical Medicine and Rehabilitation, recently made a presentation about young people and stroke at an American Therapeutic Recreation Association convention. In her review of recent medical literature, she found that general risk factors are the same for older and younger populations, though a variety of individual circumstances and medical conditions may also contribute to a young person’s risk.
“There is concern that young people are eating less-healthy diets and getting less regular exercise, and there is evidence of increased hyperlipidemia (unhealthy levels of fat in the blood), obesity, and diabetes in college students,” Lukomski says. “All of these conditions are stroke risk factors for everyone, regardless of age. But while these risk factors can be managed in most cases, there are some factors—such as family history, race, or gender—that individuals cannot control.”
Among risk factors, trends, and observations related to strokes that affect young people:
• Across all age groups, more men than women have strokes, but it is a fatal occurrence in more women than men. (Twice as many women die from stroke than from breast cancer.) In the 18- to 45-year-old age group, more women than men suffer strokes.
• Women over age 30 who smoke and take high-estrogen oral contraceptives have a stroke risk 22 times higher than average.
• Women who are pregnant have a slightly increased risk of stroke.
• Young people may be more likely than older people to downplay or disregard the symptoms of a stroke or a transient ischemic attack (a “small” stroke that causes only temporary symptoms). But people who have had a previous stroke or transient ischemic attack—whether acknowledged or not—are at greatly increased stroke risk.
• Smoking, the use of illicit drugs, and excessive consumption of alcohol all increase stroke risk.
• Sports injuries, cervical (neck) manipulations, or aggressive neck massage may cause small tears in the wall of the carotid or vertebral arteries, allowing blood clots to form. These actions may also dislodge the clots, which then could travel to the brain, causing a blockage and stroke.
Lukomski and her counterpart at another local hospital recently asked former patients under age 55 to complete questionnaires about their quality of life. About half of the respondents indicated they were unable to return to work. More than 70% said they experienced depression, anxiety, or fluctuating moods.
“A stroke affects work, leisure activities, and relationships,” Lukomski says. “It often affects mood, communication with others, physical capabilities, and thinking skills needed to solve problems, follow through with recovery, and achieve a desired quality of life. All stroke survivors need ongoing help to continue to heal and progress toward their personal goals of normalcy, but young stroke survivors may need additional assistance with parenting, dating, developing careers, attending school, engaging in higher risk or active leisure interests, and using computers and other technology.”
In addition to the Young Person’s Support Group, Cedars-Sinai offers support for stroke victims of all ages. These groups are part of an extensive community outreach program that provides education and screening in the community, often targeting high-risk populations, such as the elderly and African-American communities.
“Stroke is the third leading cause of death and the number one cause of adult disability," Palestrant says. "Recent studies have found that early intervention can improve outcomes by about 30%. Therefore, any time a person is having symptoms of a stroke, getting immediate help at a specialized stroke center is critical.”
Cedars-Sinai’s Stroke Program is certified as a Primary Stroke Center by The Joint Commission, and recently received its second consecutive Gold Award from the American Stroke Association for success in using the “Get With The Guidelines—Stroke” program, a designation given to centers that have maintained high performance levels for 2 years or more.