March 11, 2019
By Nirav Shah, M.D., Sentinel CEO and Dr. David Liebeskind, M.D., Director of the UCLA Stroke Center
Most people think that strokes only strike down the elderly. And so, when a celebrity like Luke Perry, who exudes perpetual youth, dies of a stroke, the world is taken by surprise.
Perry’s unfortunate passing is a reminder that stroke can impact people of all ages, including those we consider young. It also offers us an important opportunity to reflect on a growing public health crisis — a rise in stroke in young adults. According to the American Heart Association, approximately 10 percent of strokes occur in people between the ages of 18 and 50 — a staggering number. (https://www.heart.org/en/about-us/heart-and-stroke-association-statistics). Increasing use of detailed imaging tests, such as MRI, will likely uncover much higher rates of injury in the brain.
As stroke neurologists, we have spent our careers thinking about how to treat, and to prevent, strokes for the entire population. Until recently, only our grandparents — people over the age of 55 — were the focus of stroke prevention campaigns. But more and more, we are seeing younger patients arrive in the emergency room presenting with symptoms of a stroke.
We believe it is of the utmost importance that younger people understand the risk factors, as well as the signs and symptoms of stroke. The story of a young stroke patient illustrates the pressing need for increased education, awareness and action.
A couple years ago, one of us was called in to the emergency room to see a 33-year-old woman who had woken up that morning with weakness on one side of her body and was having trouble difficulty speaking — symptoms that were not very different from Perry’s. Similar to him, she appeared healthy to casual observers. She was newly married, had a burgeoning career as a marketing manager, and had just begun a workout regimen.
She had deliberated over whether to go to the hospital at all. Should she just go back to sleep, and hope her symptoms, which seemed odd to her, would pass? It never occurred to her that she was at risk of a stroke, as she was not familiar with the most common symptoms of the most frequent cause of disability worldwide.
Luckily, her husband encouraged her to get medical attention. She survived, and her stroke team was able to identify the cause of her stroke — a case of undiagnosed, unusually high blood pressure. We worked together to control her blood pressure, and she had a long, steady and complete recovery.
We have heard many similar anecdotes from our neurology colleagues in states across the country. And multiple researchers have documented a doubling in incidences of stroke in people in their 20s-40s since the 1990s.
While the precise reason for the increase in the prevalence of stroke currently evades us, it is likely that rising rates of drug and substance abuse, and growing numbers of people with obesity, type 2 diabetes, and hypertension are the culprits. In addition, advanced imaging technology has enabled physicians to identify strokes that once might have gone undiagnosed.
Fortunately, these risk factors are preventable in most people.
Which brings us to the importance of spreading awareness about stroke prevention and the symptoms of stroke to people who likely don’t know they are at risk of the disease — young adults.
These symptoms are the same as they are in older populations, and include loss of special, facial droop, and weakness on one side of the body.
While there is no magic bullet when it comes to preventing strokes, the medical community has been extremely successful at reducing rates of stroke in adult males over the age of 65 by instructing patients to follow the American Heart Association “Simple 7” a list of lifestyle changes that includes managing blood pressure, controlling cholesterol, reducing blood sugar, getting active, eating better, losing weight and stopping smoking.
While researchers continue to uncover both the causes of, and the best ways to prevent stroke across all genders, ages and ethnicities, the AHA’s guidelines are a good place to start for most people.
The precise details around the cause Luke Perry’s stroke have not been identified. His death at the young age of 52 is certainly a tragedy.
But we hope that his death will serve to heighten awareness around stroke prevention, awareness and action – a stark reminder that strokes don’t happen only to older people.