Why do young people have strokes?

Researchers from the Centenary Institute, Sydney, have announced a breakthrough in understanding the cause of stroke in young people. The leader of the research, Dr Xiangjian Zheng, said the stroke in question affects around five in every 1000 people, many of whom are diagnosed in their 30s and 40s.

The study, published in the journal Development Cell, focused on the molecular basis of cerebral cavernous malformations (CCMs) - collections of small blood vessels which enlarge in the brain and form irregular thin structures. The researchers explained, “The cerebral cavernous malformation (CCM) pathway is required in endothelial cells for normal cardiovascular development and to prevent postnatal vascular malformations, but its molecular effectors are not well defined.”

Through genetic studies in mice and zebrafish, and molecular analysis in human endothelial cells, the team uncovered a new molecular connection between the loss of activity in CCM genes and weakened blood vessels in the brain - a major cause of haemorrhagic stroke. Loss of CCM signalling in endocardial cells “results in mid-gestation heart failure associated with premature degradation of cardiac jelly”, said the researchers, who added that “CCM deficiency dramatically alters endocardial and endothelial gene expression”.

Dr Zheng said this finding is vitally important because there is presently no non-surgical treatment for this cause of stroke. Given the location of affected area in the brain, surgical treatment is not possible for many patients.

“In discovering this molecular link, we now have a better understanding of how and why this type of stroke occurs,” Dr Zheng said.

“It is only with this type of knowledge that we can now look towards a treatment and prevention of this devastating disease.”