STROKE

Stroke is one of the most devastating disorders globally demonstrating 1-month case-fatality rates ranging from 13 to 35%. The majority of cases appear in the advanced age population groups demonstrating well-acknowledged risk factors such as sedentary lifestyle, smoking, overweight, hypertension and abnormal sleep patterns. However, alarming statistics are provided by more recent studies demonstrating a persistently increasing stroke incidence in adolescents and young adults:

“Young” stroke (< 50 years of age) is a multifactorial disease frequently described as being of unclear aetiology and therefore unpredictable by considering “traditional” risk factors listed above.

CASE REPORT

A 24-year-old female was presented as a stroke patient. She exhibited right-sided hemiparesis moderate at the upper extremity, mild in the lower extremity and with mild Broca’s aphasia. Multimodal CT was normal. A severe headache gradually developed, and hemiparesis and aphasia resolved. MRI ruled out stroke. The diagnosis was migraine with aura presented as a stroke mimic. In medical history, the patient suffered from headache in stressful situations and perimenstrual headache, overactive bladder, stress urinary incontinence, sleep disorder - falling asleep and insomnia, cold intolerance, excessive sweating, unpleasant perceived joint hypermobility, neck and low back pain and stress eating disorder accentuated during the university exam period. Clinical findings are as follows: weight 45 kg, height 171 cm, BMI ˂16. Blood pressure in sitting position 102/60, asthenic figure, joint and spine hypermobility, acrocyanosis and acral hyperhidrosis, stress skin stains and faltering stress speech. In summary, the patient was diagnosed with migraine with aura presented as a stroke-like episode (stroke mimics).

Patient was evidently under-weight and demonstrated strongly pronounced vascular dysregulation, abnormal stress reactions and altered sleep patterns – all factors are modifiable and, therefore, preventable.