Impact of Gender on Risk Factors and Stroke Etiology in Young Ischemic Stroke Patients: A Retrospective Observational Study.

Introduction: The lack of clarity regarding the upper age limit for defining ischemic stroke in young individuals, and the absence of a gender-based distinction, make it difficult to determine the true incidence of stroke in young people and to standardize the approach to elucidating its etiology. This study aimed to examine the risk factors and etiology of ischemic stroke in young individuals, as well as to evaluate their distribution by gender. Methods: This retrospective, observational, single-center study evaluated stroke risk factors and etiologies in 200 patients aged 18-55 diagnosed with ischemic stroke, and their distribution among male and female patients. Results: The mean age was higher in males, who accounted for 58.5% of the patients. Smoking, alcohol use, and coronary artery disease (CAD) were more common in men, while anemia, migraine, and oral contraceptive use were more common in women. The most common etiological subgroup was stroke of other determined etiology (SODE) which was more common in women. Small vessel occlusion (SVO) was more common in men. In women, the mean ages of etiological subgroups were similar, but in men, the large artery atherosclerosis (LAA) group had a significantly higher mean age than the stroke of undetermined etiology and SODE groups. Conclusion: Risk factors and etiology showed significant differences by gender. The proportion of etiological subgroups is consistent with earlier studies where the upper age limit was lower, suggesting that 55 years of age may be an appropriate upper age limit for young stroke. However, the finding that SVO and CAD, in which classical vascular risk factors play a major role, were more frequent in men, and that the mean age of men with LAA was older than that of men in other subgroups, indicates that the upper age limit for young stroke should most likely be lower in men.