Strokes are often thought of as a problem for older adults, but a new study shows that young people under the age of 50 are also at risk—especially if they suffer from migraines or have other hidden health problems.
Researchers from Yale-NUS College and several European universities found that young adults were more than twice as likely to have a stroke from nontraditional causes like migraines than from common causes such as high blood pressure.
Stroke is when the brain’s blood supply is blocked, leading to damage. One common type is called ischemic stroke, which is caused by a blood clot.
In recent years, the number of strokes among young adults aged 18 to 49 has gone up. Many of these strokes are called “cryptogenic,” meaning doctors can’t easily find a clear cause like smoking, high cholesterol, or diabetes.
The study looked at more than 1,000 adults in Europe, with an average age of 41. Half of them had experienced a cryptogenic stroke, and the other half had no history of stroke.
Researchers studied a wide range of risk factors—both common and uncommon—and also looked closely at a heart condition called PFO, which is a small hole between the upper chambers of the heart. While a PFO is usually harmless, it has been linked to strokes.
The results were eye-opening. In people without a PFO, traditional risk factors like high blood pressure and obesity were the biggest stroke triggers. Every extra traditional risk factor increased stroke risk by 41%.
But in people with a PFO, less common risks—like migraines with aura, blood clots in the veins, kidney or liver problems, and cancer—had a much stronger connection to stroke. Each of these increased the risk by 70% or more.
For women, certain gender-specific risks such as pregnancy complications or gestational diabetes also raised stroke risk by 70%, even when other risks were considered. Among those with a PFO, each traditional risk factor increased the chance of stroke by only 18%, but nontraditional factors more than doubled the odds.
The study also looked at what would happen if these risk factors were removed. In people without a PFO, about 65% of strokes were due to traditional causes. In contrast, in people with a PFO, nearly half of the strokes were linked to nontraditional causes, and another 22% were tied to female-specific risks.
Migraine with aura was the leading nontraditional risk, responsible for nearly half the strokes among people with a PFO and almost a quarter of strokes in those without.
These findings show the need for better screening for unusual stroke risks, especially in young adults and women. Asking questions about migraines, pregnancy history, and other less obvious health problems could help doctors prevent strokes.
Dr. Jukka Putaala, the study’s lead author, said the results show why we need to carefully look at each person’s unique risk factors.
Dr. Tracy Madsen, a stroke expert who was not part of the study, added that knowing how risks vary by sex and age can help doctors provide better care. For example, young women may be at higher stroke risk due to reasons that don’t show up in traditional health checks. Recognizing these risks earlier could change how doctors screen and treat patients.
This study had some limits. It was based on past health records and patient-reported information, which might not always be exact. Also, almost all participants were white Europeans, so the results may not apply to everyone.
Still, the research is a big step in understanding strokes in young adults. It highlights the importance of looking beyond common risks and paying attention to symptoms like migraines or fatigue. With more targeted care, doctors may be able to stop strokes before they happen—even in people who seem healthy.
If you care about stroke, please read research about Stronger high blood pressure treatment may help prevent stroke in older people and findings of Stroke death risk increases again after falling for 40 years.
For more about stroke, please read research about Research finds a better high blood pressure treatment for stroke patients and findings of Scientists find a better drug than statins for stroke patients.
The study is published in Stroke.
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