Strokes can occur in younger people too

Strokes can occur in younger people too
A mild stroke in middle age, such as the one suffered by Beau Biden, isn't uncommon, doctors say. And the cause could be a number of things.

By Jeannine Stein, Los Angeles Times

May 17, 2010

The news that Delaware Atty. Gen. Beau Biden, age 41, recently suffered a mild stroke probably came as a surprise to many people, considering that the son of Vice President Joe Biden is relatively young, trim and in seemingly good health. It shouldn't have.

Strokes are not unheard-of in people that age, said Dr. David S. Liebeskind, associate director of the UCLA Stroke Center. "It doesn't surprise me at all," he said. "Overall, the perception is that only older people have strokes, but we see a lot of people who have strokes at that age, even younger sometimes."

A mild stroke could be caused by a number of things, he said, including a tear in the wall of one of the major arteries leading to the brain, causing a blockage. That could be due to arterial structural abnormalities, or from stress put on the arteries caused by a sudden twisting movement.

"Sometimes it can occur with trauma as severe as whiplash," he said, "or something like a tennis serve or a particular swimming movement or other sporting activities."

General stroke symptoms can include numbness or weakness on one side of the body, loss of speech, imbalance, trouble with speaking or speech loss, or a sudden, severe headache.

A mild stroke can also be caused by a blood clot, which, Liebeskind said, can occur anywhere in the circulatory system, cutting off blood flow to the brain.

A transient ischemic stroke, also called a mini-stroke, is the temporary blockage of an artery caused by a blood clot. A tendency to form blood clots, he added, can be something we're born with. "In many cases we're unaware of it." Infections or minor illnesses can cause inflammation, which can also lead to blood clots.

Another cause of stroke is a cerebral hemorrhage, when an artery in the brain bursts and fills the area with blood. Singer and reality show star Bret Michaels, 47, reportedly suffered a subarachnoid hemorrhage recently, a specific type of bleeding stroke that happens between the tissues around the brain and the brain itself.

Some types of migraines may also lead to a stroke, said Dr. Patrick Lyden, chairman of the department of neurology at Cedars-Sinai Medical Center.

Those who have classical migraines, he said, which include an aura and sometimes loss of vision or function on one side, may be at more risk for stroke than those who have common migraines, which typically cause pain on only one side of the head and almost never include an aura.

A statement from the vice president's office said that Beau Biden, who suffered the stroke Tuesday, was alert with complete motor and speech skills. But prognosis following a stroke depends on its cause, Lyden said, and that remains unclear. "First you think about the cause, then you think about the severity of the symptoms, then you think about how to treat it."