Stroke is often seen as a disease of old age. But in hospitals today, that assumption is starting to shift.

Neurosurgeons are increasingly treating patients in their 30s and 40s, many of them professionals with demanding careers whose conditions are linked to chronic stress, high blood pressure and undiagnosed health risks.

Indeed, more young individuals are presenting with life-threatening brain emergencies, including brain haemorrhage, severe swelling, or aneurysm rupture that may require urgent intervention to prevent permanent disability or death.

Stroke remains the third leading cause of death in Malaysia, with a significant and growing burden nationwide. In 2019 alone, nearly 48,000 new cases were recorded, alongside close to 20,000 deaths and hundreds of thousands of people living with stroke-related disability.

More concerningly, stroke incidence among adults aged 35-39 has risen sharply in recent years, reflecting the growing impact of lifestyle-related vascular risk factors. The most severe cases often involve bleeding in the brain or dangerous swelling that can rapidly worsen without timely treatment.

The role of stress

While stroke is commonly associated with conditions such as hypertension, diabetes and high cholesterol, chronic stress is emerging as an important contributor, particularly among working adults.

Prolonged stress can lead to sustained high blood pressure, poor sleep quality and metabolic imbalance. Over time, these factors increase the risk of both ischaemic and haemorrhagic stroke.

Unfortunately, common symptoms such as headaches, dizziness or fatigue are often mistaken for work-related stress rather than early neurological warning signs.

One of the biggest challenges is that many risk factors develop without obvious symptoms. High blood pressure, in particular, can gradually weaken blood vessels in the brain, increasing the likelihood of intracranial haemorrhage or aneurysm rupture.

Yet many young professionals remain unaware of these risks until severe complications arise. By the time symptoms appear, the situation may already be critical.

Not all strokes require surgery, but some can escalate rapidly into life-threatening conditions. Surgical intervention may be necessary in cases involving severe brain swelling, significant bleeding, ruptured aneurysms, or fluid buildup in the brain.

In such situations, rapid referral and treatment significantly improve survival and recovery outcomes.

Article shared by: Aidawati Ramali  |  Institutional Audit Section

Article was written by : Dr Kuha Raj Arumugam,  a neurosurgeon at Ampang Puteri Specialist Hospital.