ISCHAEMIC STROKE IN A YOUNG PATIENT

large artery disease:

premature atherosclerosis:

smoking

hyperlipidaemia

obesity

hypertension

diabetes mellitus

hyperhomocystinaemia

carotid or vertebral dissection:

Ehlers-Danlos syndrome

Marfan's syndrome

homocystinuria

cystic medial degeneration

pseudoxanthoma elasticum

fibromuscular dysplasia

other causes:

radiotherapy

moya-moya disease

small artery disease:

hypertension-associated vasculopathy

classical migraine (hemiplegic migraine)

cardio-embolism:

valvular heart disease:

mitral valve prolapse

prosthetic valves

bacterial endocarditis

Libmann-Sacks endocarditis (SLE)

other cardiac conditions:

atrial fibrillation

acute myocardial infarction (left ventricular dyskinesia with aneurysm)

left atrial aneurysm

left atrial myxoma

dilated cardiomyopathy

atrial septal defect, including patent foramen ovale

thrombophilias:

congenital:

antithrombin deficiency

protein C or S deficiency

factor V Leiden mutation

sickle-cell disease

hyperfibrinogenaemia

acquired:

antiphospholipid syndrome

myeloproliferative disorders

hyperviscosity syndrome

vasculitides:

drug abuse [heroin, cocaine, amphetamines]

cerebral lupus

polyarteritis nodosa

Takayasu's arteritis

isolated CNS angiitis

sarcoidosis

Wegener's granulomatosis

Behçet's disease

varicella-zoster arteritis

pregnancy-related:

eclampsia

post-partum cardiomyopathy

choriocarcinoma

paradoxical embolism

hypotension

other genetic causes (not already listed above):

CADASIL [cerebral autosomal dominant arteriopathy with subcortical infarcts and leucoencephalopathy]

MELAS [mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes]

Fabry's disease [X-linked recessive lysosomal storage disorder]

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