February 25, 2011

Strokes increasing among younger Americans

For 10 days in January, Margaret Stednitz's throbbing headache refused to go away.

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For 10 days in January, Margaret Stednitz's throbbing headache refused to go away.

In a hospital emergency room, a physician diagnosed a migraine. But medication did little to relieve the pain radiating down the back of her head.

Then one day during lunch, she took a sip of iced tea and couldn't swallow it.

"My arm ended up in the middle of my plate," she said. "All I wanted to do was go to sleep."

Her husband, Doug, got her to a hospital, where an MRI showed bleeding in the brain and the cause of her headache. At 34, Stednitz had suffered a stroke.

Although the Azle mother of two could hardly believe that a stroke could strike someone so young, she's not alone. A study released this month found that strokes are rising dramatically among young and middle-aged adults. The sharpest increase -- 51 percent -- came among males between the ages of 15 and 34, but there has also been a 17 percent rise among women of the same age. In the first large nationwide study of stroke hospitalization, researchers compared data from 1994 and 1995 with 2006 and 2007. The results were presented at an American Stroke Association meeting.

Strokes increased by more than 30 percent among children 5 to 14, the study found. At the same time, hospitalizations for strokes decreased among those over 65. Strokes dropped 25 percent among older men and 29 percent among older women.

Physicians suspect that the country's obesity epidemic is taking its toll. Nearly two-thirds of all Americans are overweight or obese.

Young people have the same risk factors for stroke as older people, including high blood pressure, high cholesterol, obesity, alcohol use and smoking, said Dr. Roger Blair, medical director of the Stroke Program at Texas Health Harris Methodist Fort Worth hospital. He said he has treated young people who were inactive and overweight at the time of their strokes.

The use of birth-control pills increases the risk for young women by three times. Migraines, which are more common in younger women, can increase the risk significantly. Sleep apnea and cocaine use can be contributing factors.

Greater awareness and improvements in diagnosing and treating strokes have helped improve the outcome for all ages, Blair said. But youth has its advantages.

"A younger brain holds up better to any insult than an older brain," he said.

Still, young people often ignore symptoms, and clot-busting drugs that can prevent brain damage must be taken within about three hours.

"Younger people think they're never going to get sick and that we all get headaches." Blair said. "But if you're having the worst headache of your life, you need to get to an emergency room."

Although young people still stand less chance of having a stroke than older adults, it can happen at any age, even to children. Each year, nearly 800,000 people in the United States have a stroke, which is the third-leading cause of death in the U.S. In Texas, stroke killed 9,796 people in 2007, according to the American Heart Association.

For Stednitz, the stroke on the left side of her brain stem caused paralysis on her right side. But it never affected her speech, even as she was being rushed to the hospital.

Doctors suspect birth-control pills may have caused her stroke since she has no family history or risk factors such as high blood pressure or high cholesterol.

For the past month, Stednitz has been undergoing rehab at Texas Health Fort Worth, where she is learning to walk again. In time she plans to return to her job as a scheduler for a sheet metal company.

The challenges that young adults face after a stroke are often very different from an older patient, said Connie Garcia, coordinator of Brain Injury Transition Services at Texas Health Fort Worth.

Younger people may not have the complicating medical issues that older people deal with but they have other issues, including driving, employment and parenting young children, she said.

Jan Jarvis, 817-390-7664

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