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42 patients aged up to 35 years who had suffered a stroke were analysed according to etio-pathogenetic and prognostic criteria. The cause of the stroke could be explained with certainty only in ten patients and with high probability in a further eight. In a quarter of the cases the aetiology was completely obscure. Diagnostic gaps exist especially in haemostatic, virological and cardiological areas. Three patients died from the stroke. Follow-up showed that 40% of patients were able to resume their previous occupation. Relapses were observed in cases with disseminated lupus erythematosus and endocarditis. The relatively low rate of clarified cases (42%) is partly due to selection but also to the gaps in diagnostic knowledge. Accordingly, a stepwise diagnostic program was set up, based upon urgency and technical expenditure, that took into account not only the minimal needs for a sound initial diagnosis but also the extensive differential diagnoses for less common causes of stroke.

42 patients aged up to 35 years who had suffered a stroke were analysed according to etio-pathogenetic and prognostic criteria. The cause of the stroke could be explained with certainty only in ten patients and with high probability in a further eight. In a quarter of the cases the aetiology was completely obscure. Diagnostic gaps exist especially in haemostatic, virological and cardiological areas. Three patients died from the stroke. Follow-up showed that 40% of patients were able to resume their previous occupation. Relapses were observed in cases with disseminated lupus erythematosus and endocarditis. The relatively low rate of clarified cases (42%) is partly due to selection but also to the gaps in diagnostic knowledge. Accordingly, a stepwise diagnostic program was set up, based upon urgency and technical expenditure, that took into account not only the minimal needs for a sound initial diagnosis but also the extensive differential diagnoses for less common causes of stroke.

Die Pathogenese juveniler Insulte ist bekanntermasen sehr vielgestaltig. Aus diesen Grunden ist ein umfassendes diagnostisches Programm erforderlich. Oft kann aber trotzdem die Ursache des Schlaganfalles nicht aufgeklart werden. Bisher wurden unseres Wissens nur vereinzelt Verlaufsbeobachtungen von jugendlichen Insultpatienten und jungeren Erwachsenen publiziert. Wir haben eine solche retrospektive Untersuchung durchgefuhrt. Die Untersuchung hatte drei wesentliche Ziele: 1. Es sollte anhand der Grundlagen neuerer Literaturmitteilungen gepruft werden, welche diagnostischen Lucken bei der Durchsicht der Krankenakten erkennbar waren und wie diese in Zukunft vermieden werden konnen. 2. Durch die Nachuntersuchung sollte das Ergebnis der therapeutisch rehabilitativen Masnahmen festgestellt werden, um Anhaltspunkte fur die prognostische Beurteilung solcher Patienten zu erhalten. 3. Es sollte versucht werden anhand der Nachuntersuchungsergebnisse zusatzliche Informationen uber die mogliche Pathogenese des Insultes zu erhalten.