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The causes of ischemic stroke in young people are numerous and diverse. Younger patients require a much more in-depth and comprehensive diagnostic evaluation compared with the older ones. It is important to be aware of the fact that the in-depth diagnostics makes sense, since in most cases re-stroke can be prevented. The most common causes of ischemic stroke in young patients are dissection of the neck arteries, cardio-embolism, premature atherosclerosis, haematological disorders, immunological disorders and migraine. In addition, drug abuse is becoming an increasingly important cause of stroke. The risk of certain types of stroke slightly increases during pregnancy. Isolated angiitis of the central nervous system, heritable disorders of the connective tissue and other genetically determined disorders (Fabry disease, CADASIL, mitochondrial cytopathy etc.) are rare, yet important causes of ischemic stroke as well. The diagnostics of ischemic stroke in young patients should be done in a tertiary center by a neurologist who specializes in vascular neurology. In case that the cause of ischemic stroke remains unknown despite extensive diagnostics, the risk of a re-stroke is usually low. After stroke, intensive and sometimes long-term rehabilitation is necessary for a successful re-integration of young patients in their environment. Despite the fact that the rehabilitation potential in younger patients is favorable, the patients feel the consequences of a stroke for the rest of their lives.