Why strokes can be perilous for the young
The risk of stroke increases with age. But It can be particularly dangerous for middle-aged adults.
Actor and 1990s heartthrob Luke Perry died at 52, his publicist said Monday, after a massive stroke last week. He’s one of the more than 795,000 Americans who die each year from the nation’s fifth-leading cause of death.
Doctors not involved in the “Beverly Hills, 90210” star’s care said middleaged adults such as Perry can face grave risk from brain swelling after a stroke.
“The immediate time after stroke is the most deadly for someone who is young,” said Salman Azhar, director of stroke at Lenox Hill Hospital in New York City. That’s because their brains have not yet shrunk, as they do in older adults.
“There is oftentimes no space in the brain for the swelling to happen. That in and of itself can make these strokes more fatal in the young.”
Ischemic stroke, often cause by a clot that blocks blood flow to the brain, account for 87 percent of strokes, according to the Centers for Disease Control and Prevention.
A hemorrhagic stroke, which is often more deadly, occurs when an artery in the brain leaks or ruptures. Those types of strokes can be caused by conditions such as high blood pressure or aneurysms, according to the CDC.
Doctors have not said what type of stroke Perry suffered, but either could be fatal.
Perry was reportedly alert and talking to paramedics after his stroke last Wednesday, but his condition worsened after he was taken to the hospital.
“It is possible that he might have suffered a hemorrhagic stroke that expanded and caused further deterioration,” said Shraddha Mainali, a neurologist at The Ohio State University Wexner Medical Center. “It’s also very possible he suffered an ischemic stroke.”
Mainali said intense pressure within the cranium can build to a peak three to five days after a stroke.
Azhar said younger and middle-aged patients can suffer more intense pressure from swelling following a stroke.
“Swelling happens after every stroke,” Azhar said. “That leads to shifting of brain compartments, leading to more brain damage and eventually death.”
Doctors have several options to alleviate pressure from swelling after a stroke, depending on the area of the brain that is affected. They can remove part of the skull to alleviate pressure, Azhar said. They can use a scope-type device to remove blood, or try medications to “dry the brain out.”
Risk factors for stroke include high blood pressure, high cholesterol, smoking, obesity and diabetes. One in three adults in the USA have at least one of those conditions or habits.
When a stroke occurs, speed can save lives. People who get to a hospital within three hours of their first symptoms have less disability three months later than those for whom care was delayed, the CDC says.
African-Americans’ risk for a first stroke is nearly twice as high as for whites. African-Americans also have the highest death rate from stroke.