A black and white CT scan of a brain that shows a spot in the brain where a blood clot developed

This is the CT scan of an elderly person who suddenly developed difficulties speaking. It shows bleeding in the left temporal lobe. Further testing revealed a clot in one of the veins of the brain (intracranial vein thrombosis).

Strokes do not respect age boundaries.

Everyone, from babies to the elderly, can suffer a stroke, potentially leading to devastating lifelong disabilities. While it's true that risk increases with age, strokes in young people — specifically those under 45 — are becoming more common, with recent research from the CDC finding a 14.6% increase among people ages 18 – 44 from 2020 to 2022. 

A stroke, which is the fifth leading cause of death in the United States, is a neurological condition that results from damage to a blood vessel in the brain, either from a blockage or a rupture. Without adequate blood flow, brain cells begin to die within minutes, which can lead to devastating consequences, including permanent physical and mental disabilities or even death. 

In fact, in one study, the majority of stroke survivors said that having a stroke was worse than death itself, reflecting just how devastating and life-altering strokes can be.

The most common type, ischemic stroke, accounts for roughly 85% of all cases and is caused by a blood clot interrupting the brain’s blood supply. The remaining 15% are hemorrhagic strokes, which occur when a blood vessel bursts, either within the brain or around it.

While the symptoms of a stroke may look similar across patients, Lucas Restrepo, MD, PhD, a neurologist at Loma Linda University Health, says that the underlying causes can vary widely, including drug use, poor diet, and undetected heart conditions.

“The good news is we can prevent many strokes by targeting lifestyle choices and cardiovascular risks, many of which are easy to identify and improve," he said. 

What it means to ‘have a stroke’

The main types of strokes are ischemic and hemorrhagic.

In an ischemic stroke, where a blood clot blocks an artery in the brain, the brain circulation may not immediately shut down in the affected area; rather, it tries to compensate. Nearby blood vessels begin rerouting blood to the blocked region, and as a result, only a small central area of brain tissue with very decreased circulation, known as the core, suffers irreversible damage. Surrounding this core is a larger area called the penumbra, which is functioning poorly due to limited blood flow, but is still salvageable if treated quickly. 

A hemorrhagic stroke occurs when a blood vessel in the brain bursts, causing bleeding into or around the brain, which can be caused by high blood pressure, aneurysms, or trauma. 

When someone is having a stroke — especially in the first few hours — it’s not a fixed event, but rather a dynamic and rapidly evolving process that Restrepo compares to a solar eclipse. 

“When the moon eclipses the sun, at the center, the darkness is most intense. But as you move outward, there are gradations of light,” he explains. “In a stroke, the penumbra represents this “gray area”— brain tissue not yet lost, but at risk. This is the critical area that doctors aim to save with prompt treatment.”

The primary goal in treating a stroke is to reopen the blocked artery and restore blood flow to the penumbra. This can be achieved in two main ways: a clot-busting medication or a procedure to get rid of the clot, known as a thrombectomy.

  • Clot-busting medication: TPA or TNK are clot-busting medications administered into the vein to dissolve blood clots. 

  • Thrombectomy: This is a procedure where a catheter is inserted through an artery in the groin or arm and navigated up to the site of the blockage in the brain to break up or pull out the clot. Thrombectomies can lead to remarkable recoveries, where in some cases, patients who were paralyzed on one side of the body begin moving again within a day of treatment. 

However, Restrepo warns that access to this life-saving procedure isn't universally available. 

“Not all hospitals are equipped to perform thrombectomies, which require highly trained specialists such as neurologists, neuro-interventional radiologists, or neurosurgeons,” he said. “As a result, many patients must be transferred to larger medical centers, like Loma Linda University Medical Center, that are equipped for advanced stroke care.”

Common causes of stroke among young people

The concerning rise in strokes among young people — particularly in communities with limited access to healthcare and healthy lifestyle options — is largely driven by lifestyle-related damage to the brain’s blood vessels. 

Restrepo addresses the following contributing factors below.

High blood pressure

High blood pressure is the leading risk factor for stroke. By controlling blood pressure, it cuts your risk of stroke nearly in half. Many people experience elevated blood pressure at the doctor’s office, but Restrepo acknowledges that it can be a normal response to stress or anxiety caused by rushing to the appointment, being nervous about results, or just not knowing what to expect. 

If you're concerned that stress at the doctor’s office might affect your results, checking your blood pressure at home while you're relaxed can provide a more accurate reading. If your blood pressure is consistently high, even in calm, everyday settings, talk to your doctor about treatment options. 

High cholesterol 

Similarly, managing cholesterol through diet, exercise, or medication helps prevent the buildup of plaque in arteries. When too much "bad" LDL cholesterol circulates in the blood, it can stick to artery walls, causing them to narrow and harden over time. This can limit blood flow to the brain and increase the chance of local clot formation. High cholesterol also increases inflammation, which further damages blood vessels and raises stroke risk.

Substance and alcohol use

Drugs, alcohol, and smoking can significantly increase the risk of stroke. Among the most dangerous drugs are methamphetamine and cocaine, which can spike blood pressure dramatically — sometimes even after a single use. These sudden changes in blood pressure can cause arteries to rupture or constrict severely, leading to a stroke.

“Tragically, it’s not uncommon to see young people suffer a stroke after their very first exposure to these substances,” Restrepo says. 

Additionally, excessive alcohol use can raise blood pressure dramatically, and wide fluctuations in blood pressure can lead to strokes — especially the type that involves bleeding in the brain.

Unhealthy diets

Fast food and highly processed diets play a role in promoting inflammation and the buildup of cholesterol in arteries. Over time, this damage makes the vessels more vulnerable to blockage or rupture. 

While there is a lot of misinformation about foods, such as claims that if you eat a certain superfood you’ll be protected from disease, there is good evidence that stroke prevention starts with what we eat.

Restrepo says that one of the most well-studied and evidence-backed diets for reducing stroke risks is the Mediterranean-style diet, which encourages eating fresh vegetables, fruits, legumes, whole grains, nuts, and lean proteins, especially seafood like salmon. The diet, which is more of a lifestyle than a restrictive eating plan, advises against processed foods, including sugary snacks, pastries, processed meats, and foods high in refined sugars and saturated fats.

“This isn’t just about eating at a Mediterranean restaurant — it’s a commitment to eat in a way that emphasizes whole, unprocessed foods and healthy fats,” he says. “Large clinical trials in Europe have shown that this diet outperforms even generally healthy diets in reducing stroke risk.” 

Obesity

Obesity is often linked to high blood pressure, diabetes, and poor cardiovascular health. While being overweight is not only a visible sign of potential risks, it is something that can be improved through diet, exercise, and, in some cases, medication. 

Skipping regular check-ups

Visiting a doctor can help catch potential problems before they become serious. An annual check-up can not only help identify health concerns such as high blood pressure and cholesterol, but a doctor can also identify and monitor heart health.

Atrial fibrillation (AFib), a common type of irregular heartbeat, is a particular danger that increases a person's risk of stroke up to five times. This happens when the heart’s electrical signals misfire, causing an irregular and often rapid heartbeat that promotes clotting in the left atrium. 

AFib often develops due to underlying heart conditions like high blood pressure, heart valve problems, or heart failure. Other risk factors include aging, obesity, sleep apnea, excessive alcohol use, thyroid disorders, diabetes, and stress.

Fortunately, there's a highly effective treatment for AFib: blood thinners. Although many people are hesitant to take them due to concerns about safety, Restrepo emphasizes that today’s blood-thinning medications are very safe and can dramatically reduce the risk of stroke with minimal complications.

The takeaway is simple: young people are not immune to strokes, but many of the risks can be reduced through smart, proactive choices. Maintaining healthy habits, avoiding harmful substances, and committing to regular check-ups can go a long way toward protecting brain health well into the future.

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