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Supplementary Tables Table 1


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Supplementary Tables

Table 1

Studies including more than 100 patients published since 2000 reporting stroke aetiology in young patients by TOAST criteria. All figures are percentages. Total percentage figures are from pooled numbers obtained from the individual papers. LAA Large artery Atherosclerosis, CE Cardiac embolism, SVD Small Vessel Disease, ODA Other Determined Aetiology UDA Undetermined Aetiology. a TIAs excluded from total reported cases.



Authors

Year Published

Years Studied

Country

Number

Age

LAA

SVD

CE

ODA

UDA

Chan et al.

2000

1993-1997

Canada

356

15-45

6

8

14

28

44

Kwon et al

2000

1994-7

Korea

149

15-44

21

17

18

27

17

Lee et al

2002

1997-2001

Taiwan

264

15-45

8

22

20

25

26

Naess et al

2004

1988-97

Norway

232

15-49

15

15

8

15

48

Cerrato et al

2004

1994-2001

Italy

273

16-49

16

17

24

19

24

Nedeltchev et al

2005

1997-2000

Switzerland

203

16-45

4

9

24

30

33

Rasura et al

2005

1992-2001

Italy

394

14-47

12

3

34

28

24

Varona et al

2007

1974-2002

Spain

272

15-45

20

5

18

22

36

Arnold M et al

2008

2000-06

Switzerland

137

16-45

2

3

37

31

27

Putaala J et al

2009

1994-2007

Finland

1008

15-49

8

14

20

26

33

Spengos and Vemmos

2010

1999-2008

Greece

253

≤45

7

17

16

27

34

Total (pooled numbers)










3541




10

12

21

25

32

Table 2

Table S2 Cases excluded from analysis, including causes of stroke mimics. Other causes include 1 each of transient global amnesia, Bells palsy, vestibular symptoms, musculoskeletal symptoms, and previous stroke. TIA transient ischaemic attack.


Cause




n

%

Stroke mimic

158







Migraine




76

48.4

Unspecified




34

21.7

Syncope/near syncope




14

8.9

Neuropathy




8

5.1

Seizure




7

4.5

Conversion




6

3.8

Visual other




4

2.5

Cervical myelitis




2

1.3

Other




7

4.6

TIA

29







Haemorrhage

14







Incomplete details

9








Table S3 cases of cardiac embolism by TOAST, ASCO1 and ASCO2 criteria with attributed cause. ASA atrial septal aneurysm, DCM dilated cardiomyopathy, MI myocardial infarction





TOAST

ASCO1

ASCO2

Isolated PFO

14

0

0

PFO with ASA

4

0

4

Atrial fibrillation

6

6

6

Atrial septal defect

2

2

2

Congestive heart failure

1

1

1

DCM ( 1 with recent MI)

2

2

2

Infective endocarditis

1

1

1

Total

30

12

16

Supplementary References

[1-22]

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2 Carolei A, Marini C, Ferranti E, Frontoni M, Prencipe M, Fieschi C: A prospective study of cerebral ischemia in the young. Analysis of pathogenic determinants. The national research council study group. Stroke 1993;24:362-367.

3 Adams HJ, Kappelle L, Biller J, Gordon D, Love B, Gomez F, Heffner M: Ischemic stroke in young adults. Experience in 329 patients enrolled in the iowa registry of stroke in young adults. Arch Neurol 1995;52:491-495.

4 Qureshi AI SK, Patel M, Janssen RS, Frankel MR.: Stroke in young black patients. Risk factors, subtypes, and prognosis. Stroke 1995;26:1995-1998.

5 Barinagarrementeri F, Figueroa T, Huebe J, Cantú C: Cerebral infarction in people under 40 years i. Etiological analysis of 300 cases prospectively evaluated. Cerebrovasc Dis 1996;6:75-79.

6 Williams L, Garg B, Cohen M, Fleck J, Biller J: Subtypes of ischemic stroke in children and young adults. Neurology 1997;49:1541-1545.

7 Siqueira Neto J, Santos A, Fabio S, Sakamoto A: Cerebral infarction in patients aged 15 to 40 years. Stroke 1996;27:2016-2019.

8 Kristensen B, Malm J, Carlberg B, Stegmayr B, Backman C, Fagerlund M, Olsson T: Epidemiology and etiology of ischemic stroke in young adults aged 18 to 44 years in northern sweden. Stroke 1997;28:1702-1709.

9 Kittner S, Stern B, Wozniak M, Buchholz D, Earley C, Feeser B, Johnson C, Macko R, McCarter R, Price T, Sherwin R, Sloan M, Wityk R: Cerebral infarction in young adults: The baltimore-washington cooperative young stroke study. Neurology 1998;50:890-894.

10 Chan MT, Nadareishvili ZG, Norris JW: Diagnostic strategies in young patients with ischemic stroke in canada. Can J Neurol Sci 2000;27:120-124.

11 Kwon S, Kim J, Lee J, Lee M: Ischemic stroke in korean young adults. Acta Neurol Scand 2000;101:19-24.

12 Lee T, Hsu W, Chen C, Chen S: Etiologic study of young ischemic stroke in taiwan. Stroke 2002;33:1950-1955.

13 Naess H, Nyland H, Thomassen L, Aarseth J, Myhr K: Etiology of and risk factors for cerebral infarction in young adults in western norway: A population-based case-control study. Eur J Neurol 2004;11:25-30.

14 Cerrato P, Grasso M, Imperiale D, Priano L, Baima C, Giraudo M, Rizzuto A, Azzaro C, Lentini A, Bergamasco B: Stroke in young patients: Etiopathogenesis and risk factors in different age classes. Cerebrovasc Dis 2004;18:154-159.

15 Nedeltchev K, der Maur T, Georgiadis D, Arnold M, Caso V, Mattle H, Schroth G, Remonda L, Sturzenegger M, Fischer U, Baumgartner R: Ischaemic stroke in young adults: Predictors of outcome and recurrence. J Neurol Neurosurg Psychiatry 2005;76:191-195.

16 Rasura M, Spalloni A, Ferrari M, De Castro S, Patella R, Lisi F, Beccia M: A case series of young stroke in rome. Eur J Neurol 2006;13:146-152.

17 Varona J, Guerra J, Bermejo F, Molina J, Gomez de la Cámara A: Causes of ischemic stroke in young adults, and evolution of the etiological diagnosis over the long term. Eur Neurol 2007;57:212-218.

18 Putaala J, Metso A, Metso T, Konkola N, Kraemer Y, Haapaniemi E, Kaste M, Tatlisumak T: Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke the helsinki young stroke registry. STROKE 2009:1195-1203.

19 Balci K, Utku U, Asil T, Celik Y: Ischemic stroke in young adults: Risk factors, subtypes, and prognosis. Neurologist 2011;17:16-20.

20 Spengos K, Vemmos K: Risk factors, etiology, and outcome of first-ever ischemic stroke in young adults aged 15 to 45 - the athens young stroke registry. Eur J Neurol 2010;17:1358-1364.

21 Arnold M, Halpern M, Meier N, Fischer U, Haefeli T, Kappeler L, Brekenfeld C, Mattle HP, Nedeltchev K: Age-dependent differences in demographics, risk factors, co-morbidity, etiology, management, and clinical outcome of acute ischemic stroke. J Neurol 2008;255:1503-1507.

22 Musolino R, La Spina P, Granata A, Gallitto G, Leggiadro N, Carerj S, Manganaro A, Tripodi F, Epifanio A, Gangemi S, Di Perri R: Ischaemic stroke in young people: A prospective and long-term follow-up study. Cerebrovasc Dis 2003;15:121-128.





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