BACKGROUND AND PURPOSE: Stroke subtypes and prognosis differ among older black 
patients compared with whites; however, few data are available regarding stroke 
among young black patients.
METHODS: To determine the risk factors for stroke, stroke subtype, and prognosis 
among young black patients, we retrospectively reviewed the medical records of 
all 15- to 44-year-old patients admitted with stroke to a university-affiliated 
public hospital from January 1990 through June 1994.
RESULTS: Of the 248 eligible patients admitted with stroke, 219 were blacks. 
Hypertension was more frequently associated with stroke in young black than in 
non-black patients (55% versus 24%, P = .003). Cocaine abuse was frequent among 
both black and non-black patients (27% versus 38%, P = NS). Hypertensive 
intracerebral hemorrhage (64%) was the most common subtype of intracerebral 
hemorrhage (n = 67), and lacunar infarction (21%) was the most common subtype of 
cerebral infarction (n = 112) in young black patients. Outcome in black patients 
with stroke at discharge was 69% independent, 8% dependent, and 23% dead.
CONCLUSIONS: The high frequency of hypertension, hypertensive intracerebral 
hemorrhage, and lacunar infarction among young black patients with stroke 
suggests accelerated hypertensive arteriolar damage, possibly due to poor 
control of hypertension.