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In reply
I thank Drs Ferro and Crespo for their kind comments about the recent article describing the causes of ischemic stroke in young adults. The data from their excellent studies in Lisbon, Portugal, differ slightly from the Iowa experience, possibly because of the reasons outlined in their letter.Some of the young adults encountered by us were hospitalized with other medical problems when strokes occurred. Some of these persons had severe diseases that probably influenced the courses of their illnesses. Still, stroke was a major cause of morbidity and, in some cases, mortality. Because ischemic stroke happens with some regularity in hospitalized young adults and because the causes of ischemic stroke may differ, it is important to include these patients in registries such as ours and the one that Drs Ferro and Crespo have in Lisbon.I strongly agree that additional information about the causes and prognosis of ischemic