This question is prompted by this story.
For a 26-year-old to have a stroke, is this just bad genes? Substance abuse? Bad diet? Bad luck? How common is it for a 26-year-old to have a mini stroke?
IANOD but it’s not altogether uncommon. It’s my understanding that a stroke isn’t always a sign of degenerative disease or old age. Some examples:
A friend of mine had a stroke at 23. Just a bolt from the blue. It happens.
I had a friend who had a stroke when he was about 33. He recovered from it in triple-quick time, though.
Strokes occurring in young people are usually due to a different set of risk factors and conditions compared to those in the older population (with high blood pressure and atrial fibrillation being far and away the major causes of stroke in the elderly).
The most common cause of stroke in people under age 40 was said to be cocaine (ab)use (sorry, no cite).
That said, there is a huge number of other potential causes:
Younger people are more likely than older folks to have undiagnosed stroke-promoting congenital heart lesions (especially patent foramen ovale). Likewise, young people’s greater tendency to use IV drugs compared to older individuals, predisposes the young to certain heart infections which can cause strokes.
Certain familiar and genetic syndromes, each predisposing to strokes, are also more in common in the young, e.g. MELAS syndrome, moyamoya disease.
A stroke occurring in a young person should prompt consideration of the existence of an underlying hypercoagulable state, i.e. a tendency for the blood to clot spontaneously (with the clots so formed causing a stroke). The list of causes of ahypercoagulable state is lengthy but includes conditions such as various genetic clotting disorders, lupus and lupus-associated diseases (e.g. antiphospholipid antibody syndrome), cancer, kidney disease (nephrotic syndrome), and many more.
Muniz actually had a transient ischemic attack, according to sources I’ve seen. It’s often called a “mini-stroke”, but it really isn’t a stroke at all. It’s caused by a small blood clot.
Absolute baloney. One possible cause? Sure. But the most common causes of strokes in young people are related to cardiac disease.
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[li]“In young people the most common causes are high blood pressure or sickle cell disease.” (cite)[/li][li]"Principal causes [of ischaemic stroke in young adults] are extracranial arterial dissection, cardioembolism, premature atherosclerosis, haematological and immunological disorders and migraine. "(cite)[/li][li]One-fifth to one-third of strokes in the young may be caused by cardioembolic phenomena. Causes include congenital heart disease, valvular disease (including endocarditis) and arrhythmias. (cite)[/li]
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Also, actress Aubrey Plaza has discussed having a stroke at age 20.
but this thread reminded me of something that happened to me about thirty years ago while I was in college. I woke up, showered, shaved, dressed and went down to the dining hall for breakfast. I hadn’t spoken to anyone yet but as I moved through the cafeteria line, the first words out of my mouth were complete gibberish. My friends thought I was being silly but I was horrified. Long story short, my speech returned after about twenty minutes. Hadn’t thought about it in years and yes, perhaps I should have seen a doctor, but I’ve always wondered that was. Any thoughts?
Like I said, “no cite” 
More seriously, IIRC the assertion was regarding urban US hospitals (and was made in the 90’s) so it isn’t quite as ridiculous as it may sound. In any event, I should have qualified it better (i.e. urban, US, 90’s) instead of being coy by saying “the most common cause was said to be”
A friend had a stroke in her early 20’s back around 1985. There was a considerable delay in the paramedics transporting her to the hospital because they refused to believe she wasn’t stoned, despite having no indicators appearance-wise for drug use other than her age.
Well, I suppose that works as an anti-drug message, but it also has the effect of stigmatizing younger stroke victims. Strokes (and “mini-strokes”) among people under 40 aren’t uncommon at all, which is what the OP asked, and the vast majority of those cases aren’t cocaine-induced.
Thought of another famous person who had a stroke before the age of 40: NFL linebacker Tedy Bruschi.
KG, here is one study re amphetamines, cocaine, and stroke in the young.
Figure 2 has some numbers in a pie chart.
After the usual suspects such as hypertension and tobacco, cocaine figures fairly high as an independent attributable risk, though still only 4.1 and 2.3%, respectively, for hemorrhagic and ischemic stroke in the young.
I have not researched this in detail, but I’d definitely assume the population being studied would make a large difference in these numbers.
One day about seven or eight years ago, I was getting ready to leave for work and my wife was sitting at the table eating breakfast and reading the paper. I said goodbye to her and she didn’t respond. I said goodbye again and still no response. “Are you OK?” I asked. She looked up at me and had this far-away look in her eyes and said “No…” So I helped her up and got her dressed and drove her to the hospital. On the way there, the fogginess started to clear up but she said she had double vision. It was probably a couple, three hours before she was back to normal. She told me later that while she was reading the paper the print just started moving in waves on her, and then she started feeling like she was at the end of a long tunnel. The folks in the ER said it was labyrinthitis*, but we always wondered if it was some kind of mini stroke. It was this really weird one-time thing, it never happened again.
- A couple of years later, my father-in-law woke up one morning with complete hearing loss in one ear. When he went to the hospital, they told him that was labyrinthitis. Maybe that’s what they tell you in the ER when they have no idea what’s wrong with you.
Thanks for that, Chief. Very nicely presented results.
In any case, I think I may have found the reference that formed the basis of my semi-serious assertion above. To wit:
(emphasis added)
When I was in high school, my friend’s cousin had a stroke. He was about 6. I remember her saying he was the youngest stroke patient his doctors had ever even heard of.
I assume there was some kind of cholesterol issue involved as the doctors put him on a strict vegan diet afterwards.
we’re overlooking something - there’s another kind of stroke besides the classic blocked artery mentioned so far - a rupture. IANAD and don’t know Frankie, but I would think a rupture due to structural weakness is more likely in some1 young, all other factors such as coke excluded. Anyway, he had a TIA which is considered not as bad as a stroke, but not good either - a warning of things to come.
Two men, friends-of-a-close-friend, had strokes or TIAs last year. One died. One got pretty severely brain-damaged. He lost most of his personality and friends, lost his job, and his (not so good) marriage only lasted because his wife turned out to kind of like him being dependent on her.
Both men were in their early 40’s.
I read a lot about stroke after that, and what I read was scary; stroke is fast on its way to become the number one killer and cause of invalidity. Forget cancer and forget being scared about stuff that might be carcinogenic; we should be worried about factors that increase the risk of stroke.
Here’s an article on risk factors on stroke in young people. Put in lay mens terms (if my translation from Medic is good enough) the risk factors are high blood pressure, diabetes, and having had smaller, earlier strokes.
Smoking, alcoholism, psychological stress and obesity were also risk factors, but in a far more indirect way. Nice; who of us doesn’t have any of those three?
They say that they found no evidence for a link with cocain use in that particular study:
In short, we don’t know really what causes (or even predicts) stroke, and that is scary as hell.
I’m amazed at my minor celebrity gossip recall here, but last year he had some sort of domestic violence incident where the cops were called and he was allegedly threatening suicide. So it sounds like at the very least, he has some sort of history of psychological stress.
I had a major stroke at 27, when I was in grad school–I was running five miles per day, not smoking, not obese, no history, no family history. Just woke up unable to write my name, went into the hospital, got tested, a dark cloud appeared on the brain scans, I had aphasia and extreme depression (and very limited use of my right side) for the next 6 months/year, and have recovered fully since.
The most recent research indicates that the primary factor contributing to arterial plaque formation is the distribution of LDL particles sizes.
This is a more in depth article.
This lists the lab tests that will quantify your risk.