Abstract Number: Esoc2026a2088 Left Anterior vs Right Anterior vs Posterior Circulation Infarcts: A Retrospective Study of Young Adults With Ischaemic Strokes

Abstract Background and aims Ischaemic stroke in young adults is a growing clinical challenge, with distinct risk profiles compared to older populations. Posterior circulation infarcts (PCI) comprise 20% of cases, yet comparative data on anterior versus posterior infarcts and hemispheric lateralisation in this cohort remains limited. Methods We retrospectively analysed patient records of adults aged ≤ 55 admitted to a hyperacute stroke unit between January 2024-June 2025. Haemorrhages, multiregional/embolic infarcts and prior strokes were excluded. Demographics, risk factors and NIHSS (Welch’s t-test) were analysed. Results 49.1% (147/299) of young adults admitted in this timeframe were included, of which 31.9% were left anterior infarcts (LAI), 26.5% right anterior infarcts (RAI) and 30.1% were PCI. Median age was 50 (22-55) for LAI, 48 (23-55) for RAI and 50 (18-55) for PCI. Males were more likely to have all regional infarcts, though females had their highest percentage in RAI (36.4%). Males had a higher mean NIHSS than females in all but RAI (5.96 to 8.88). There was no significant difference in mean NIHSS between LAI and RAI in males (p=0.43) and females (p=0.11). 30% of PCI were associated with diabetes, 18.1% of RAI and 13.2% of LAI. Thrombolysis rates were 18.1% in RAI, 13.2% in LAI and 12% in PCI. Conclusions The increased incidence of diabetes in PCI patients highlights that patient subgroups may benefit from targeted risk factor management. The higher proportion of RAI in young females further emphasises the importance of considering both stroke location and risk profiles for early intervention strategies. Conflict of interest Arunan Varatharsan: Nothing to disclose Duaa Ali Faruqi: nothing to disclose. Teswahen Bedawi: nothing to disclose. Aravinth Sivagnanaratnam: Nothing to disclose.