Thesis defense Loes Rutten-Jacobs (Donders Series 154)

14 April 2014

Promotor: Prof.dr. M.A.A.P. Willemsen, Copromotors: Dr. H.F. de Leeuw, dr. E.J. van Dijk

Long-term prognosis after stroke in young adults

Stroke is one of the leading causes of death with an annual 6 million fatal events worldwide. , Although stroke mainly affects elderly people, still approximately 10% occurs in patients younger than 50 years. Whereas elderly stroke is among the most studied topic in medicine, there are only limited data on stroke in young adults. Long-term prognosis is particularly important in adults in these ages, given that they have a long life expectancy during a demanding period of life in which they start to form families, have an active social life and make decisive career moves. Prognosis of young stroke in terms of mortality is generally considered to be benign, given that short-term mortality and is lower compared to older stroke patients.

The studies described in this thesis investigated the long-term mortality and risk of recurrent vascular events after stroke in young adults in the FUTURE-study. The FUTURE study is a prospective cohort study designed to investigate etiologies and long-term consequences of a TIA, ischemic stroke, or intracerebral hemorrhage in 1008 adults, aged 18-50 years , admitted to the Radboud university medical center between January 1, 1980 and November 1, 2010.

The studies described in this thesis showed that young stroke patients have a much poorer long-term prognosis than previously thought. Young adults with stroke remained at a probably life-long increased risk of vascular disease and premature death compared with their healthy peers. These results stress the need for probably life-long adequate monitoring and control of risk factors and life style in these young patients.