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目的：探讨４０岁以下急性脑卒中的病因、卒中类型与预后的关系。方法：回顾性分析１９９０年１月～１９９８年１２月４０岁以下急性脑卒中３５９例，占同期收治急性脑卒中２８６４例的１２．５３％。结果：３５９例中，缺血性卒中１７４例、出血性卒中１８５例，前者有病因可寻者１４３例（８２．１８％），其中心源性脑栓塞４０例（２２．９９％）、钩端螺旋体脑动脉炎３２例（１８．３９％）、高血压２０例（１１．４９％）、长期口服避孕药１１例（６．３２％）、偏头痛和头颈部外伤各１０例（５．７５％），其余为脑动－静脉畸形、Ｍｏｙａ－Ｍｏｙａ病和糖尿病。出血性卒中：高血压４２例（２２．７２％）、先天性颅内动脉瘤３８例（２０．５４％）、脑动－静脉畸形２２例（１１．８９％）、血液系统疾病２２例（１１．８９％），其余为头颈部外伤和 Ｍｏｒａ－Ｍｏｙａ病。本组急性期基本痊愈率达 ７６．３２％，死亡率 １０．０３％，其中出血性卒中死亡率１３．０３％，白血病并发脑出血死亡率最高，占出血性卒中的４２．２１％，缺血性卒中死亡率６．７０％。结论：表明青少年脑卒中预后与病因、卒中类型密切相关。
Objective: To investigate the etiology, stroke type and prognosis of acute stroke after 40 years old. Methods: From January 1990 to December 1998, 359 acute stroke patients under 40 years of age were retrospectively analyzed, accounting for 12.53% of 2864 cases of acute stroke admitted in the same period. Results: Among the 359 cases, 174 cases were ischemic stroke and 185 cases were hemorrhagic stroke. The former had 143 cases (82.18%) of whom the cause was found, 40 cases (22.99%) of them had central encephalopathy, 32 cases (18.39%) of acute cerebral arteritis, 20 cases of hypertension (11.49%), 11 cases of long-term oral contraceptives (6.32%), 10 cases of migraine and head and neck trauma .75%), the rest were cerebral arteriovenous malformations, Moya-Moya’s disease and diabetes. Hemorrhagic stroke: hypertension in 42 cases (22.72%), congenital intracranial aneurysms in 38 cases (20.54%), cerebral arteriovenous malformations in 22 cases (11.89%), hematological diseases in 22 cases 11.89%), the rest were head and neck trauma and Mora-Moya disease. The basic recovery rate of this group during acute phase was 76.32%, the mortality rate was 10.03%, of which hemorrhagic stroke mortality rate was 13.03%. The mortality rate of cerebral hemorrhage complicated by leukemia was the highest, accounting for 42.21% of hemorrhagic stroke, Bloody stroke mortality 6.70%. Conclusion: The prognosis of adolescent stroke is closely related to the etiology and type of stroke.