Dutch researchers have found that cola drinking, strenuous exercise, sexual activity, use of illegal drugs, but especially fever and flu-like illnesses 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 triggers, such as short-term exposure to toxins or an infection, might play a role. They asked patients aged 18 to 49 with a first ischemic stroke or intracerebral hemorrhage (ICH) to complete a questionnaire about exposure to 9 potential triggers during pre-defined risk periods and an average over the previous year.
The questionnaire was completed by 1,146 patients, of which 1,043 with ischemic stroke and 103 with ICH (median age 44.0 years, 52.6% male). Stroke risk increased within 1 hour after cola consumption (RR 2.0) and strenuous exercise (RR 2.6), within 2 hours after sexual activity (RR 2.4), within 4 hours after drug use illicit (RR 2.8) and within 24 hours of fever or influenza-like illness (RR 14.1 and RR 13.9). Strenuous 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 triggers become a risk factor in order to provide tailored prevention.
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