{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T15:16:39Z","timestamp":1791126999571,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose:<\/jats:title>\n            <jats:p>Acute ischemic stroke due to large vessel occlusion is uncommon in young adults. We assessed stroke cause in young patients and compared their outcomes after endovascular thrombectomy with older patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We used data (March 2014 until November 2017) of patients with an anterior circulation large vessel occlusion stroke from the MR CLEAN (Multicenter Randomized Controlled Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) Registry, a nationwide, prospective study on endovascular thrombectomy in the Netherlands. We compared young patients (18\u201349 years) with older patients (\u226550 years). Outcomes included modified Rankin Scale score after 90 days (both shift and dichotomized analyses), expanded Thrombolysis in Cerebral Infarction score, and symptomatic intracranial hemorrhage. Analyses were adjusted for confounding.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              We included 3256 patients, 310 (10%) were 18 to 49 years old. Young patients had lower median National Institutes of Health Stroke Scale scores (14 versus 16,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and less cardiovascular comorbidities than older patients. Stroke etiologies in young patients included carotid dissection (16%), cardio-embolism (15%), large artery atherosclerosis (10%), and embolic stroke of undetermined source (31%). Clinical outcome was better in young than older patients (acOR for modified Rankin Scale shift: 1.8 [95% CI, 1.5\u20132.2]; functional independence [modified Rankin Scale score 0\u20132] 61 versus 39% [adjusted odds ratio, 2.1 [95% CI, 1.6\u20132.8]); mortality 7% versus 32%, adjusted odds ratio, 0.2 [95% CI, 0.1\u20130.3]). Symptomatic intracranial hemorrhage occurred less frequently in young patients (3% versus 6%, adjusted odds ratio, 0.5 [95% CI, 0.2\u20131.00]). Successful reperfusion (expanded Thrombolysis in Cerebral Infarction Score 2b-3) did not differ between groups. Onset to reperfusion time was shorter in young patients (253 versus 255 minutes, adjusted B in minutes 12.4 [95% CI, 2.4\u201322.5]).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Ten percent of patients with acute ischemic stroke undergoing endovascular thrombectomy were younger than 50. Cardioembolism and carotid dissection were common underlying causes in young patients. In one-third of cases, no cause was identified, indicating the need for more research on stroke cause in young patients. Young patients had better prognosis and lower risk of symptomatic intracranial hemorrhage than older patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.120.034033","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T10:00:41Z","timestamp":1638871241000},"page":"34-42","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":38,"title":["Endovascular Thrombectomy in Young Patients With Stroke: A MR CLEAN Registry Study"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0301-2616","authenticated-orcid":true,"given":"Josje","family":"Brouwer","sequence":"first","affiliation":[{"name":"Department of Neurology, Amsterdam UMC, University of Amsterdam, the Netherlands (J.B., Y.B.W.E.M.R., J.M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna A.","family":"Smaal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Maastricht University Medical Center, the Netherlands (J.A.S., I.R.d.R., R.J.v.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1222-0652","authenticated-orcid":true,"given":"Bart J.","family":"Emmer","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, the Netherlands (C.B.M., B.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger R.","family":"de Ridder","sequence":"additional","affiliation":[{"name":"Department of Neurology, Maastricht University Medical Center, the Netherlands (J.A.S., I.R.d.R., R.J.v.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3734-6086","authenticated-orcid":true,"given":"Ido R.","family":"van den Wijngaard","sequence":"additional","affiliation":[{"name":"Department of Neurology and Radiology, Haaglanden Medical Center, the Hague, the Netherlands (I.R.v.d.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2221-3026","authenticated-orcid":true,"given":"Frank-Erik","family":"de Leeuw","sequence":"additional","affiliation":[{"name":"Department of Neurology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands (F.-E.d.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7593-5674","authenticated-orcid":true,"given":"Jeannette","family":"Hofmeijer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rijnstate, Arnhem, the Netherlands (J.H.)."},{"name":"University of Twente, Faculty of Science and Technology, Enschede, the Netherlands (J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1631-7056","authenticated-orcid":true,"given":"Wim H.","family":"van Zwam","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, the Netherlands (W.H.v.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9418-4503","authenticated-orcid":true,"given":"Jasper M.","family":"Martens","sequence":"additional","affiliation":[{"name":"Department of Radiology, Rijnstate, Arnhem, the Netherlands (J.M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9205-5882","authenticated-orcid":true,"given":"Yvo B.W.E.M.","family":"Roos","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam UMC, University of Amsterdam, the Netherlands (J.B., Y.B.W.E.M.R., J.M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7600-9568","authenticated-orcid":true,"given":"Charles B.","family":"Majoie","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, the Netherlands (C.B.M., B.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1032-9099","authenticated-orcid":true,"given":"Robert J.","family":"van Oostenbrugge","sequence":"additional","affiliation":[{"name":"Department of Neurology, Maastricht University Medical Center, the Netherlands (J.A.S., I.R.d.R., R.J.v.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8284-982X","authenticated-orcid":true,"given":"Jonathan M.","family":"Coutinho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam UMC, University of Amsterdam, the Netherlands (J.B., Y.B.W.E.M.R., J.M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the MR CLEAN Registry 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