Psychostimulant use is associated with increased stroke risk. To determine the proportion of psychostimulant users among fatalstrokes in young adults (15–44 years), all cases were retrieved from the National Coronial Information System (1/1/2009–31/12/2016). A totalof 279 cases were identified: hemorrhagic (259), ischemic (8), thrombotic (8), and mycotic (4). Fifty (17.9%) were identified as psychostimu-lant users. Psychostimulants in blood were detected in 37/45 where toxicology was available, predominantly methamphetamine (32/45). Hemor-rhagic strokes in the psychostimulant group were more likely to be intraparenchymal (OR 2.33). Psychostimulant users were less likely to beobese (OR 0.31), but more likely to have a history of tobacco use (OR 2.64). No psychostimulant user had a previous stroke history, wasgravid/postpartum, or diagnosed with cerebral vasculitis or endocarditis. The work illustrates the substantial role of psychostimulant use in fatalstrokes among young adults. In cases of hemorrhagic stroke among young adults, psychostimulant use should be considered.
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