Rare genetic and hereditary diseases, such as Fabry
disease, cerebral autosomal dominant arteriopathy with
subcortical infarcts and leukoencephalopathy (CADASIL),
and mitochondrial encephalopathy with lactic acidosis and
stroke-like episodes (MELAS), must be considered in the
differential diagnosis of young patients with ischemic stroke.
Vasculitides of the central nervous system are complex
diseases and often reminded when differential diagnosis of
stroke in young adults is discussed. Primary cerebral angiitis
is twice as common in middle-aged men than in women,30 and
vasculitis related to infection is more common in developing
countries and in regions with a higher prevalence of human
immunodeficiency virus.31