The threat of stroke in young people is rising

Experts from Christchurch Group, which operates eight neuro rehabilitation services across the UK, are warning that generations X and Y are at an ever-increasing risk of stroke.

NHS figures support this view, with the number of men aged 40 to 54 hospitalised after stroke hitting 6,221 last year – 46 per cent higher than in 2000. For women in the same age group, there was also a 30 per cent rise.

Stroke Consultant Liz Iveson, who works at Woodlands Neurological Rehabilitation Centre in York, explained more:

“Strokes were traditionally considered a disease of the retired and while most strokes do still occur over the age of 65, poor lifestyle choices are increasingly putting younger generations at risk.

“The situation is made worse by the challenges faced in spotting symptoms; a stroke can go undetected and can hide behind the mask of other problems such as migraine, vertigo or drugs and alcohol.

“Stroke tends to be the thing that’s thought of last by both doctors and younger patients. As a result, we see delayed presentation and diagnosis. In young people, who are generally considered low risk, this delay can be devastating.

“The speed at which patients are diagnosed and treated can be hugely significant to the outcome of a stroke. Most acute treatments which can “clot bust” the cause of the Stroke can only be given up to 4.5 hours after the onset of stroke symptoms.  Misdiagnosis or delayed presentation puts young people’s lives at risk or sets them up for a lifetime of severe disability.”

There is a national strategy
for stroke patients within healthcare trusts that has been rolled out over the last decade by the Royal College
of Physicians (RCP). This is helping to counter the threat of late detection or misdiagnosis of stroke among
young people. Dr Iveson believes that there are some good initiatives in place to tackle the problem, including the  ‘stroke pathway’, dedicated stroke units and the appointment of hyperacute stroke nurses.

Dr Iveson said: “We’re definitely getting better at diagnosing stroke in younger patients. Because of the pathway, the stroke team has a greater presence in A+E. If doctors are unsure about symptoms, they can ask the stroke nurse to have a look at a patient. Ambulance staff are also key and will often pre-alert the stroke team of a patient with suspected stroke – ‘Time is Brain’  (This term is used to emphasise the importance of speed in the treatment in Acute Stroke – for every minute delay in opening up the blood vessel that’s blocked and restoring blood flow to the brain – 1.9 million brain cells are lost).

“A more challenging task is tackling the stroke risk factors seemingly on the rise in younger people. Obesity – which increases your risk of diabetes, stress, high blood pressure, smoking, alcohol and drug use have all been identified as key contributing factors. Ultimately, the longer you have these risk factors or make these lifestyle choices, the more likely you are to have a stroke.

"However, with time and specialist rehabilitation delivered by a multidisciplinary stroke team, young stroke patients can do surprisingly well. We’ve seen younger patients that have had very severe strokes resulting in extensive brain damage, that have gone on to walk, recover speech and live independent lives.

“Stroke Rehabilitation is available for a reasonable time in the NHS but longer-term neurorehabilitation and psychology is difficult to get – and often younger patients can continue to Improve for a long-time post stroke. The acute care for patients with stroke have improved hugely over the last 15 years, the next challenge is to improve the provision of longer term specialist neurological rehabilitation and support.”