Strokes are often thought of as a health problem for older people, but that’s starting to change. More adults under the age of 50 are now having strokes, especially strokes caused by blood clots. These types of strokes are known as ischemic strokes.
Even more worrying is that many of these strokes don’t have a clear cause. Doctors call them “cryptogenic strokes,” meaning they can’t figure out why they happened.
A new study published in the journal Stroke by the American Heart Association may help explain some of these mysterious cases. The researchers believe that a small opening in the heart, called a patent foramen ovale or PFO, could be a part of the problem.
A PFO is a hole between the upper left and right chambers of the heart. It’s something that many people are born with, and in most cases, it never causes any issues. But for some people, it might raise the risk of having a stroke.
In this study, scientists looked at 523 people between the ages of 18 and 49 who had experienced cryptogenic strokes. They compared them with 523 people of the same age who had never had a stroke. The data came from a long-term European study called SECRETO, which involved participants from 13 countries over nearly a decade.
The researchers weren’t just looking at the usual stroke risk factors like high blood pressure, smoking, diabetes, and obesity. They also studied less commonly known risks.
These “nontraditional” risk factors included conditions like cancer, blood clots in the veins, kidney disease, and migraines that come with visual symptoms, such as flashes of light — a type called migraine with aura.
Interestingly, migraine with aura was the most common nontraditional factor among people who had cryptogenic strokes, especially in women and those with a PFO.
For women in particular, the researchers found that health issues related to pregnancy — like gestational diabetes and preeclampsia — were more common among those who had strokes compared to those who didn’t, regardless of whether they had a PFO.
The study showed that in stroke survivors with a PFO, each additional nontraditional risk factor more than doubled the odds of having a stroke. For those without a PFO, the risk still went up by 70% with each added nontraditional factor.
Lead author Dr. Jukka Putaala, who heads the stroke unit at Helsinki University Hospital in Finland, said the team was surprised by how strongly migraines and other less typical risks were linked to strokes in younger adults.
He said doctors should take these risks more seriously — especially in women — and ask about migraines, cancer, kidney problems, and pregnancy-related health issues when assessing stroke risk.
Another expert, Dr. Tracy Madsen from the University of Vermont, who wasn’t involved in the study, said the breakdown by age and sex was important.
She explained that younger women might face higher stroke risks than men their age, but in middle age, men usually catch up or surpass women in risk. Recognizing these differences could help doctors better screen and educate their patients.
It’s important to note that this was an observational study. That means it doesn’t prove that these nontraditional risks cause strokes — it only shows a connection. Also, since most of the participants were white and from Europe, we don’t know if the results apply to people of other backgrounds.
Still, the findings are useful. They show that strokes in younger adults can’t always be explained by the usual causes. Sometimes, health problems that are not normally seen as stroke risks — like migraines or pregnancy complications — could play a bigger role than we thought.
Dr. Putaala said that about half of all strokes in younger adults are cryptogenic. So if we want to prevent more of these strokes, we need to start asking better questions — and not just focus on blood pressure and cholesterol. A more complete picture of a person’s health could help doctors catch risks earlier and save lives.
If you care about stroke, please read studies that diets high in flavonoids could help reduce stroke risk, and MIND diet could slow down cognitive decline after stroke.
For more health information, please see recent studies about antioxidants that could help reduce the risk of dementia, and tea and coffee may help lower your risk of stroke, dementia.
The research findings can be found in Stroke.
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