Clinical Profile and Cognitive Outcomes in Young Stroke Patients: A Prospective Observational Study

Abstract

Introduction: Stroke in young adults represents a critical and emerging health challenge, with increasing incidence. This prospective observational study aimed to comprehensively analyze the clinical characteristics, risk factors, and cognitive outcomes of stroke patients aged 18-45 years. We investigated the etiology, clinical profile, and cognitive outcomes of stroke in young adults.
Methodology: A prospective observational study was conducted at Department of Neurology Kasturba Medical College-Manipal from November 2023 to August 2024, involving 34 patients aged 18-45 years with confirmed ischemic stroke. Comprehensive diagnostic workups included blood investigations, neuroimaging, and cardiovascular assessments. Outcomes were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Montreal Cognitive Assessment (MoCA), and Modified Rankin Scale (mRS) at baseline and 3-month follow-up.
Results: The majority of participants (63.8%) were between 36-45 years, with a near-balanced gender distribution (52.8% female). Dyslipidemia (82.4%) being the most common risk factor. Significant improvements were observed across neurological and cognitive assessments. NIHSS scores improved from 4.56 to 2.56 (p=0.0001), MoCA scores increased from 22.09 to 25.38 (p=0.0001), and mRS scores decreased from 1.82 to 1.09 (p=0.001). Strong correlations were found between neurological deficits, cognitive function, and functional outcomes.
Conclusion: The study highlights the complex nature of stroke in young adults, emphasizing the importance of early intervention, comprehensive assessment, and multidimensional rehabilitation strategies. Modifiable risk factors such as dyslipidemia, hypertension, and smoking emerge as critical targets for prevention.