Kevin Hudson didn't stray from his routine, nor did he have any risk factors for a stroke.
The 45-year-old Lakewood resident was at the gym in January 2023 when the symptoms first hit. He said he's always been careful to maintain a healthy lifestyle with good diet and exercise, so a stroke wasn't among his concerns.
During his usual workout at the local YMCA, though, his eyesight became blurry. He sat down to drink some water with the assumption that he merely stood up too fast, but when he tried to continue his weight workout, the blurred vision continued.
"I got through just a couple of reps and I thought, 'Yeah I feel like something's not right. I don't need to do this right now. I want to go home,'" Hudson said.
He drove home, thankful there was little traffic. He met his wife, a Cleveland Clinic nurse, at home. She performed a neurological check on him and advised him to lay down for 20 minutes. Once she left for work, Hudson took her advice but found his symptoms had worsened after 20 minutes.
"I opened my eyes and my vision returned. But as I sat up, my arm just sort of limped to my side and I thought, 'That's not good,'" Hudson said. He called his wife who immediately returned home. As they spoke on the phone, it became clear that Hudson's symptoms were serious, so his wife called 911.
"She was asking me questions and I understood what she was asking me and I knew how to respond, but I couldn't say it. All I could say was, 'Yeah,'" Hudson said.
Paramedics rushed Hudson to the hospital, where it was confirmed he was having an ischemic stroke, a blockage that prevents blood from reaching all areas of the brain. He underwent surgery where doctors inserted stents to open the blood vessels, and then spent four days in the hospital.
Hudson was shocked to learn he'd had a stroke, given his active lifestyle and annual physicals that never indicated any risks. He now advises others to listen to their bodies, no matter their fitness level.
"Be aware of what your body's going through," he advised. "If something does happen, you can respond quickly because time is always the biggest factor in terms of how well you'll end up recovering."
New research reveals concerning trends
Hudson is one of many younger adults who have suffered a stroke, which is part of an alarming trend, said Dr. Abbas Kharal, a Cleveland Clinic neurologist.
The rise in stroke factors among U.S. adults age 18 to 50 has resulted in some concerning patterns, he said. The incidence of stroke for adults age 20 to 44 has increased from 17 per 100,000 U.S. adults in 1993 to 28 per 100,000 U.S. adults in 2015, according to research.
Though the type of stroke Hudson suffered is becoming more common in younger adults, Kharal recently researched a more severe form of stroke that has also become more prevalent.
Kharal's recent research found that younger adults have also been suffering large-vessel occlusion acute ischemic strokes (LVO-AIS), which were previously thought to occur primarily in older adults. LVO-AIS are considered to be the most debilitating strokes, which occur due to blockage of large cerebral arteries usually from blood clots or plaque buildup, according to Cleveland Clinic.
Kharal's research confirmed that the younger adult population can have risk factors for these types of large vessel occlusion strokes, and have them at similar rates to older adults.
Cleveland Clinic looked at more than 1,200 young adult stroke patients from 2017 to 2021 in Ohio. Of that group, nearly 20% had large-vessel occlusion ischemic strokes.
"We have patients in their 30s who are presenting, and I know in my clinic I have two patients who are in their 20s presenting with stroke," Kharal said. "This is not just like your 48-year-old patient with stroke. These are patients presenting in their 20s and 30s."
Researchers don't definitively know why more younger adults are suffering strokes. Kharal said there were some limitations in the study's data but he wasn't surprised by the results, given the rise in risk factors for stroke and their prevalence among younger adults, including diabetes, high blood pressure, high cholesterol and smoking — not necessarily of cigarettes but of marijuana.
"This is a very Midwestern population, where stroke risk factors are high compared to, say, Boston or New York City, where people are a lot more athletic or more aware of risk factors," he explained. "But overall, particularly the patients in the 30s and into their early 40s, it used to be surprising to me that these patients are developing strokes but honestly, not anymore."
Kharal noted another concern among the study group: lack of treatment. Half of the patients received no medical intervention, while 25% of those did not receive acute intervention because they arrived at the hospital too late for IV thrombolysis and thrombectomy.
"Perhaps better awareness needs to be raised in younger adults to emphasize that younger adults are not immune to strokes," Kharal said. "Recognizing stroke symptoms is paramount and seeking immediate medical attention for that is very important."
How to recognize a large vessel occlusion ischemic stroke
Kharal said symptoms for a LVO-AIS are severe and may include full face weakness, arm weakness or limb paralysis, complete loss of speech, abnormal eye movement or sudden unresponsiveness.
"These are big strokes from big blockages happening at the start or the origins of bigger vessels," he said. "These are not subtle symptoms where [you] have a headache and [your] face is tingling. These are hard to mimic or hard to not pick up on."
If stroke patients receive care within 4 1/2 hours, Kharal said they should be eligible for IV thrombolysis and mechanical thrombectomy, which are proven to result in the best outcomes.
