The most common symptoms of stroke, including loss of speech, facial droop, and weakness on one side of the body are the same in this younger age group as those in the older age group. Other symptoms can include vision loss, double vision, slurred speech, dizziness, or difficulty walking.

Identifying stroke as a cause for these symptoms is often delayed by a lack of recognition that stroke can happen to someone in this younger age range.

The majority of strokes occur in people who are 65 or older. As many as 10% of people in the U.S. who experience a stroke are younger than 45.

In the older age group, stroke is most often caused by atherosclerosis—cholesterol-laden plaque that hardens in the arteries and interferes with blood flow. Even in younger people, risk factors such as diabetes, high blood pressure, high cholesterol, and cigarette smoking can lead to atherosclerosis. Certain heart and hematologic conditions also need to be considered.

Some drugs, infections, and inflammatory conditions can also lead to stroke in young people. Some causes of stroke in young people may be genetically influenced. In 25-35% of young people, an exact cause for stroke cannot be identified.

About 80-85% of all strokes at any age are caused by a clot blocking blood flow in the brain. This is called an ischemic stroke. The first line of treatment for stroke in the young is the same as stroke in the older population.

When appropriate, some patients are given a clot-dissolving medicine called tissue plasminogen activator (tPA). Doctors may also decide to disrupt or retrieve a clot by threading a tiny catheter through an artery to where the clot is.

If no other health conditions are present that might interfere with stroke recovery, younger people tend to recover better from stroke damage than older people. Recovery in young people may also continue for a longer time period.

Doctors believe that improved recovery may be connected to the younger brain’s natural ability to use undamaged brain circuits to take over the functions of damaged circuits. In older patients, that brain plasticity may be reduced, but recovery does continue.

Smoking increases the risk of stroke. Controlling traditional risk factors, like high blood pressure or diabetes, is essential regardless of age. Some specific and relatively rare genetic conditions, such as sickle cell anemia, have been associated with stroke in young people.