Young stroke workup is indicated for individuals under 45. CTA is preferred for arterial dissection due to superior visualization of intramural hematoma. Antiplatelet therapy is as effective as anticoagulation for cervical artery dissections in many cases. CADASIL diagnosis can often be made clinically using family history and characteristic MRI findings (anterior temporal lobe and external capsule white matter changes) without requiring laboratory confirmation.

Young stroke workup is indicated for individuals under 45 years of age.Antiphospholipid syndrome: arterial and venous thrombosis, pregnancy complications, antiphospholipid antibodies.Classic carotid dissection triad: unilateral headache/neck pain, stroke/TIA, partial Horner syndrome.Carotid dissection causes: spontaneous or traumatic (hyperextension, rapid deceleration).Young stroke additional causes: cervical artery dissection, PFO, hypercoagulable states.CTA is preferred for arterial dissection imaging due to superior intramural hematoma visualization.Antiplatelet therapy is as effective as anticoagulation for cervical artery dissections in many cases.Genetic stroke syndromes are monogenic disorders where stroke is a primary disease manifestation.CARASIL: recessive, HTRA1 mutations, associated with hair loss and early spinal disease.CADASIL: autosomal dominant, migraines with aura, recurrent ischemic events, progressive cognitive decline, anterior temporal lobe and external capsule MRI changes.CADASIL can often be diagnosed clinically using family history and characteristic MRI findings.