Stroke of alarm: Rising cases among young spark concern, Bengaluru doctors call it public health emergency

BENGALURU: In a worrying finding, a recent study published in the International Journal of Stroke has revealed that 13.8% of stroke cases in India occur in individuals below the age of 45. The research draws on data from the Indian Council of Medical Research's (ICMR) National Stroke Registry Programme, the largest stroke registry in the country.

The study identified hypertension, smokeless tobacco use and diabetes as the key modifiable risk factors driving strokes among younger individuals. It also noted that nearly 50% of patients presented with moderate stroke severity.


According to doctors TOI spoke to, Bengaluru mirrors the national trend. They estimate that at least 20% of the acute stroke cases they treat each month involve young patients, underscoring a growing and concerning pattern.

Doctors say even paediatric strokes are no longer rare. "Just a couple of days ago, a 12-year-old boy admitted under my care suffered a stroke. He was playing cricket, came home, and a few hours later, his parents noticed he had weakness on the right side. Upon evaluation, we found he had a stroke with narrowing of the brain blood vessels," said Dr BK Madhusudhan, lead consultant, neurology, Aster RV Hospital.

He added that causes in younger patients are very different from the elderly. "Heart rhythm abnormalities, genetic disorders, blood clotting issues, and autoimmune conditions like lupus or SLE play a role. We also saw strokes from viral cerebral arteritis, where blood vessel inflammation occurs, particularly during infections in children."

Doctors noted that the early onset of lifestyle diseases such as diabetes and hypertension significantly raises stroke risk among younger individuals, the study found. They added that excessive consumption of alcohol, use of illegal substances and tobacco further compound the danger.

"Lifestyle factors such as sedentary work, lack of physical activity, stress leading to excessive cortisol production, poor sleep, smoking, alcohol use and obesity appear to be driving the rise in young strokes," said Dr Prapti Reddy, consultant neurologist, dept of neurology, Hosmat Hospitals.

Prevention must be policy priority: Docs

Neurologists noted that younger patients may experience greater impact compared to older patients.

"Elderly patients develop collaterals in the brain because of long-standing diabetes, hypertension and other risk factors. The brain blood vessels become stiffer over time and the brain starts remodelling, recruiting smaller new vessels, leading to collateral formation. In young patients, the brain is full; there is no brain atrophy. So even if there is a stroke of moderate size, the brain swelling will be significant compared to elderly patients and thus a higher impact.

The socioeconomic damage is greater too, as these are people in their prime careers, unlike those over 60 who are often retired with settled families," said Dr Suryanarayana Sharma PM, senior consultant neurologist and stroke specialist, academic adviser, department of neurology, Apollo Hospitals, Bannerghatta Road.

Neurologists called for young strokes to be considered a public health emergency and stressed that prevention must become a policy priority. They suggested that hypertension screening should begin as early as school and college levels, stroke awareness and the BEFAST protocol should be included in textbooks, families with a history of aneurysms should undergo screening, and infrastructure must be strengthened to ensure more hospitals are stroke-ready.