Dying from a stroke - like Miss Hawaii Teen Sheryl Wolfe - is highly unusual for teenagers: docs

Strokes in teenagers - like the one that led to the death of Miss Hawaii Teen United States Sheryl Wolfe this week at just 18 years old - are unexpected, devastating and, fortunately, very rare. The incidence ranges from .06 to two cases for every 100,000 kids and teens, said Michael DeGeorgia, director of the center for neurocritical care and a neurology professor at University Hospitals Case Medical Center in Cleveland, Ohio.

Ischemic strokes, caused by lack of oxygen to the brain, are more common than hemorrhagic, or bleeding, strokes. “It’s not that these kids who get strokes are drinkers or smokers or that they have clogged arteries,” he said.

“It’s usually a clotting abnormality in an otherwise healthy artery or an abnormality in the heart that causes a clot to form. If it goes to the head, it can cause a stroke.”

Another reason for an ischemic stroke is the dissection, or tearing, of a blood vessel that supplies the brain, De Georgia said.

“This can be caused by injuries in sports like hockey, football and wrestling,” he said . “But research suggests that the person this happens to has an inherited connective tissue disease that results in a weakness in the artery wall.

” Teens with sickle cell disease have a higher stroke risk, said Dr. Toby Gropen, chairman of neurology at Long Island College Hospital.

“Strokes can’t easily be predicted, but a family history of clotting abnormalities, miscarriages or cardiac disease at a young age should prompt some discussion with the family doctor,” Gropen said.

Some strokes in young people could occur because they have an autoimmune disease like lupus, said Dr. Steven Wolf, director of pediatric neurology at St. Luke’s and Roosevelt Hospitals, and birth control pills can raise the risk of stroke, but very slightly.

As for making lifestyle changes to prevent stroke, doctors say the best course of action is simply to be aware of family history. If someone in your family had a brain aneurysm or AVM that results in a bleeding stroke, that raises the risk a little bit, for example.

The survival statistics for bleeding strokes are sobering. Half of these stroke victims die, and half of those who survive have a permanent disability.

“If you survive a bleed, a good number of those people are left with a permanent disability of some type, whether it is motor or cognitive,” said Dr. Max Wiznitzer, pediatric neurologist at Rainbow Babies and Children’s Hospital in Cleveland, Ohio. “But the risk of death from ischemic stroke is much lower.”