How common is it for women in their 40's to stroke?

A fellow caregiver asked...

I am a 48 year old female. R Basal Ganglia Stroke on 1.17.09. My left-sided weakness has improved. I have a slight foot drop and some left side coordination issues. My right eye blurs and I have muscle tightness/spasm. Otherwise I am very healthy. There is no known reason for my stroke. Q: How common is it for women in their 40's to stroke? (I have heard of two in my area so far...)

Expert Answer

James Castle, M.D. is a neurologist at NorthShore University HealthSystem (affiliated with The University of Chicago) and an expert on strokes.

At the age of 48, it is certainly not unheard of to have a stroke. However, it is still quite rare and deserves a throrough evaluation. Unlike a stroke in an older person, a stroke at the age of 48 cannot be assumed to be from the standard risk factors of "hardening of the arteries", and I try to leave "no stone unturned", as the saying goes.

Your evaluation should include an MRI of the brain, a non-invasive angiogram of the brain and neck (either CT angiogram or MR angiogram) - a simple ultrasound of the neck is not sufficient, a hypercoaguable (clotting) panel, a special ultrasound of the heart called a transesophageal echocardiogram, and a prolonged telemetry of the heart electrical rhythms. Even with this list above, a large minority of patients will never have an identifiable cause found. However, I think it makes most sense to do a very thorough evaluation and try to identify some of the causes of stroke in a young person. These include clotting disorders, inborn heart defects, or small tears in the arteries.