Causes of Beau Biden's stroke

Beau Biden, son of Vice President Joe Biden, suffered a stroke today.

He is 41-years old, and is expected to make a full recovery according to the medical director of the Center for Heart and Vascular Surgery at Christiana Care Health System:

Biden has what the doctors “believe to be a mild stroke,” according to Gardner. “[He is] “fully alert, in stable condition and has full motor and speech skills.”

He’s being transferred to a tertiary care facility in Philadelphia for further observation.

What are some of the causes of a stroke in a previously healthy, 41-year old man?

There are several. Blood vessel diseases, like an arterial dissection, along with cardiac defects, predisposition to clotting (otherwise known as a hypercoagulable state), smoking, diabetes, and illicit drug use all are potential risk factors.

In his age group, a clot coming from the heart or an arterial dissection are the most common causes, at 20 and 15 percent respectively.

If you remember several years ago, New England Patriots linebacker Tedy Bruschi suffered a stroke from a heart defect. In a post discussing the case, I commented on several possibilities:

One is a patent foramen ovale (PFO). This is a condition where there is an opening between the upper two chambers of the heart that fails to close after birth. It is detected in about 25 to 40 percent of adults. A meta-analysis has suggested that those with a PFO have more than a 3-fold risk of stroke in those less than 55 years of age. Another congenital abnormality, an atrial septal aneurysm (ASA), can also be associated with a PFO. The presence of both further increases the risk of stroke by 15-fold.

Arterial dissection, which is a tear of the arteries from minor trauma, is also plausible. Connective tissue disorders like Ehlers-Danlos syndrome and Marfan syndrome can be risk factors for a dissection.

Stroke can present with a variety of symptoms, including seizures, altered mental status, focal weakness, language impairment (aphasia), visual disturbance, seizures, headache, or lethargy.

A non-contrast head CT is the test initially ordered, and in many cases, followed up with a brain MRI.

Thankfully, the younger Biden seems to be doing well. Tedy Bruschi went on to play several years of professional football after his stroke.

Leean Hendrix, a Miss America pageant contestant, suffered a stroke at age 26 from a heart defect. She wasn’t so lucky, and now continues to deal with speech and partial paralysis.

Stroke impacts people of all ages.