Dutch researchers found that drinking cola, intensive exercise, sexual activity, use of illegal drugs, but especially fever and flu-like illness are possible triggers for a stroke in young adults. They also found differences in the type and number of triggers associated with different etiological subgroups of ischemic stroke.
To gain more insight into the etiology of (cryptogenic) stroke in young adults, Merel Ekker and colleagues investigated whether certain triggering factors, such as short-term exposure to toxins or an infection, could play a role. They asked patients aged 18-49 years with a first ischemic stroke or intracerebral haemorrhage (ICH) to complete a questionnaire about exposure to 9 potential triggers during predefined risk periods and averaged over the previous year.
The questionnaire was completed by 1,146 patients, of whom 1,043 had an ischemic stroke and 103 an ICH (median age was 44.0 years, 52.6% male). The risk of stroke was increased within 1 hour after consumption of cola (RR 2.0) and strenuous exercise (RR 2.6), within 2 hours after sexual activity (RR 2.4), within 4 hours after using illicit drugs (RR 2.8) and within 24 hours of fever or flu-like illness (RR 14.1 and RR 13.9). Intense physical exertion and sexual activity increased the risk of both ischemic stroke and ICH, while cola consumption, illicit drug use, fever or flu-like illness alone increased the risk of ischemic stroke.
The researchers conclude that future research should focus on how, when and in which patients trigger factors become a risk factor in order to provide tailored prevention.
Bron:
Ekker MS, Verhoeven JI, Rensink K, et al. Trigger Factors for Stroke in Young Adults: A Case-Crossover Study. Neurology. 2022 Sep 20. Online ahead of print.