Stroke Under 55: What Everyone Should Know

When most people think about stroke, they picture an older adult. But stroke can happen much earlier in life, sometimes affecting people in their 30s, 40s, and 50s.

A Tear That Can Lead to Stroke

A stroke can change life in an instant. For younger adults, it can interrupt careers, family life, and plans for the future.

A tear in an artery in the neck, called cervical artery dissection, causes one in five strokes in people under 55. While researchers still don't fully understand why it happens, a recent UVA Health study has uncovered new genetic clues that could bring them closer to an answer. The findings may one day help researchers identify people at higher risk and explore new approaches to stroke prevention.

"Stroke is a devastating disease at any age," says Andrew M. Southerland, MD, MSc, UVA Health stroke expert and researcher. "People suffering cervical artery dissections are often young or in the prime of their adult years and are therefore even more prone to the disabling impact of this sudden, often unexplained occurrence."

What Is Cervical Artery Dissection?

This condition occurs when a tear develops in an artery that supplies blood to the brain. Blood can collect within the arterial wall and restrict blood flow, leading to a stroke.

Neck trauma, such as whiplash, is one cause of artery tears. However, many occur without a clear cause. That's what makes them so difficult to predict.

The UVA Health study uncovered a distinct pattern of activity in 11 genes among people with cervical artery dissection. Researchers hope these clues will help explain why the condition occurs, and eventually lead to better ways to prevent strokes.

The findings are preliminary, but they provide an important starting point for future research.

Younger Adults and Strokes

Although older age is a risk factor for stroke, younger adults aren't immune. Because many younger people don't consider themselves at risk, they may not recognize warning signs or seek care right away when symptoms appear.

The good news is that awareness can make a difference. Prompt treatment can reduce disability and improve outcomes.

What Are the Signs of a Stroke in Young Adults?

Recognizing stroke symptoms right away is critical.

• Balance: Is there a sudden loss of balance?
• Eyes: Sudden blurry vision, double vision, or blindness?
• Face: Does one side of the face droop?
• Arms: Is one arm weak or numb?
• Speech: Is speech slurred or difficult to understand?
• Time: Call 911 immediately.

Other possible symptoms include:

• Sudden confusion
• Trouble seeing in one or both eyes
• Dizziness or loss of balance
• Severe headache with no obvious cause

Never try to wait it out. A stroke is a medical emergency.

How Can You Help Prevent a Stroke?

Healthy habits still matter. Researchers will continue to study how genes and biology cause strokes. But keeping your blood vessels healthy is still very important.

Consider:

• Managing blood pressure
• Staying active
• Not smoking
• Managing cholesterol and diabetes
• Seeing your healthcare provider regularly

While these steps can't prevent every stroke, they can help reduce many known risk factors.

A Step Toward Prevention

The findings also highlight how researchers across UVA Health come together to investigate complex medical questions. The study brought together experts from the Department of Neurology, Department of Public Health Sciences, and Department of Genome Sciences (previously Center for Public Health Genomics), as well as the UVA Stroke Center.

"Research like this depends on both collaboration and participation," Southerland says. "We're grateful to the patients who took part and to the many colleagues whose expertise made these findings possible."

Researchers say that larger studies are needed to confirm their findings. But spotting biological clues is an important step toward understanding who may be at risk.

Southerland explains, "Understanding the genetic and environmental risk factors associated with cervical artery dissection takes us a step closer to identifying those at most risk and, ideally, preventing it from occurring."

And that is the goal: Moving from treating strokes after they happen to preventing them.

The UVA Health study was sponsored by a grant from the American Heart Association/American Stroke Association (AHA/ASA NCRP 13CRP14140001).