Introduction: The Enigma of Early-Onset Cryptogenic Stroke
Ischemic stroke in young adults—those aged 18 to 49—presents a significant clinical challenge. Unlike older populations where atherosclerosis and atrial fibrillation are the predominant drivers, nearly half of all strokes in younger patients are classified as cryptogenic, meaning they remain of undetermined origin despite extensive diagnostic evaluation. Recent research has increasingly pointed toward transient triggers that may tip the homeostatic balance toward thrombosis. Among these, infections have emerged as a primary suspect, potentially acting through complex thromboinflammatory pathways. The SECRETO study (Stroke in Young Fabry Patients, Early-onset Cryptogenic Stroke Study) provides new, multicenter evidence characterizing the association between preceding infections, coagulation biomarkers, and the risk of early-onset cryptogenic ischemic stroke (CIS).
