Alex Wilson-Garza was talking to her husband when her face started to feel like it was ‘melting off.’
In the middle of their conversation, the 24-year-old had begun slurring and stumbling over her words. Within seconds, the left side of her body weakened and she could no longer walk.
The couple’s conversation – about their weekend Brazilian jiu jitsu class – cut off as the left side of her mouth drooped and the room spun around her. ‘The only thing I remember was I was so dizzy,’ Wilson-Garza, now 28, told the Daily Mail.
Like tens of thousands of women across the US, Wilson-Garza was experiencing a stroke. Only, she didn’t fit the profile of a typical patient.
But now doctors are warning that there are unexpected catalysts, including specific types of exercise and a contraceptive taken by millions, that can spur the onset of strokes in young people without any other risk factors. And cases are soaring.
Despite the seemingly obvious symptoms, Wilson-Garza, a nurse herself, and husband Caleb Garza had no idea what was happening within her body because she was young and healthy.
‘My husband was trying to put on my shoes and he was saying, “We’re going to the emergency room right now. I don’t know what’s wrong with you, but there’s something wrong.”‘
At first, she refused, partly because the closest emergency room to their Austin, Texas, home was the one she worked at as a nurse.
Alex Wilson-Garza (pictured above with her stepson) suffered a massive stroke at just 24, despite being healthy and having no obvious risk factors
She protested, too worried about letting her coworkers see her ‘at what felt like a low point.’ But when she saw Caleb’s normally calm exterior crack, instead showing terror, she relented.
In the emergency room, Wilson-Garza’s speech went back to normal, but the doctor immediately noticed she was ‘walking like a drunk girl’ and activated the hospital’s stroke protocol.
‘I really appreciate his recognition of that because I think if I ever went anywhere else, because of my age, I don’t think they would have understood that’s not actually how [I] walk. Something’s off,’ she said.
Brain scans revealed Wilson-Garza had suffered a massive stroke in her brain’s right hemisphere. The event occurs when blood flow to a large area of the brain becomes blocked and the disruption deprives the brain of oxygen, killing nearly two million neurons during every minute without treatment.
Often dubbed a silent killer, strokes have long been considered an older person’s medical emergency, brought on by years of high blood pressure, irregular heartbeats, smoking, poor diet, obesity and diabetes.
Nearly 800,000 Americans suffer a stroke every year – adding up to one every 40 seconds – and 130,000-160,000 of them are deadly.
About three in four strokes occur in adults over 65, and the risk doubles every ten years after age 55.
But experts fear there is a new face of stroke emerging.
‘I like to think I’ve lived a very healthy lifestyle my entire life,’ Wilson-Garza told the Daily Mail. ‘I’ve been an athlete my entire life, played basketball, tennis, I run, I work out, I do Brazilian Jiu Jitsu, and I’ve never had any medical problems.’
A 2024 CDC report, using the latest data available, found that strokes in people under 45 have skyrocketed by 15 percent since 2011 – that’s twice the increase seen in Americans of all ages.
Meanwhile, stroke incidence is declining in people over 65.
Many of these young patients, like Wilson-Garza, are active, healthy and have no obvious risk factors for the condition, which is considered part of a larger group of diseases called cardiovascular disease (CVD).
‘We are clearly seeing a shift in the epidemiology of cardiovascular disease, with more strokes in younger adults and [heart attacks] occurring in individuals without traditional risk factors,’ Dr Sanjay Rajagopalan, professor of cardiovascular medicine at Case Western Reserve University in Ohio, told the Daily Mail.
‘While obesity, diet and sedentary behavior remain important, they do not fully explain this trend.’
Dr Rab Nawaz Khan, neurologist and stroke physician at MyMigraineTeam, told the Daily Mail that in young patients ‘who look very healthy on the surface, stroke can come from causes that are less obvious than the classic older-patient profile.’
‘In younger women in particular, migraine with aura is one of the most important stroke clues that can be missed,’ he added.
Wilson-Garza is a lifelong athlete, playing basketball and doing Brazilian jiu jitsu with her husband. However, stroke is on the rise in young adults like her
Migraine auras are temporary sensory disturbances like flashes of light or blurry spots. In women under 45, auras are thought to nearly double the risk of stroke because they temporarily constrict blood vessels in the brain, increasing the likelihood of clots forming.
Migraines are also significantly more common in women – they account for about three in four migraine patients. Strokes also occur in about 55,000 more women annually than men, and women under 35 are about 44 percent more likely to experience stroke than men in the same age group.
‘Women have a distinct and often underrecognized risk profile [for stroke],’ Rajagopalan said. ‘Hormonal factors, including oral contraceptives and hormone therapy, as well as pregnancy-related complications such as preeclampsia, can increase long-term vascular risk.
‘At the same time, cardiovascular symptoms in women are more likely to be under-recognized, which can delay diagnosis and treatment.’
Young people without obvious risk factors may have underlying vascular damage beneath the surface.
One leading cause of stroke in young adults is cervical artery dissection, a tear in the neck’s carotid or vertebral artery. This can be triggered by intense exercise like jiu jitsu, weight training or sudden head movements, cutting off blood supply to the brain. Wilson-Garza does not think jiu jitsu caused her stroke.
Wilson-Garza was able to get back to work three weeks after her stroke, and jiu jitsu after two months. She credits her rebound to her healthy lifestyle
While the stroke came as a shock given her lifestyle, doctors said she caught it early enough for them to administer the medication tenecteplase (TNK), a clot-buster that is most effective within 4.5 hours of symptom onset.
Wilson-Garza also underwent a thrombectomy, which involved inserting a catheter into the femoral artery in her groin to remove the rest of the clot from her brain.
She told the Daily Mail that while her experience as a nurse helped her get medical assistance quickly, she had never encountered a stroke patient younger than their late 30s.
‘I’ve never had a patient who’s had as stroke with my age,’ she said. ‘Typically they’re just older people with lots of comorbidities like [atrial fibrillation], or they have blood clotting disorders or are just a bit on the unhealthier side.
‘It was never anyone like me who’s been healthy their entire life.’
Wilson-Garza only had to spend three days in the hospital following her stroke and did not need to complete rehabilitation, which she noted may have been due to her active lifestyle. But many patients have lasting complications such as paralysis, cognitive impairment, speech issues and mental health disorders including depression.
After three weeks, she was back at work as an ER nurse.
‘I was very proud of myself,’ she said. ‘It was the first time in my life that I kind of slowed down.’
Around two months after her stroke, she was able to return to jiu jitsu after building up to it with short walks around her apartment complex and light workouts at the gym.
In the months after her stroke, Wilson-Garza underwent a battery of tests to find an answer as to what may have caused it, but none could identify any underlying heart conditions or obvious risk factors such as congenital defects or clotting disorders.
Wilson-Garza has been named one of the American Heart Association’s Go Red for Women Class of Survivors, which celebrates young, otherwise healthy women who have survived different types of heart disease and stroke
Doctors told her the only possible risk factor they could find was her birth control, which contained small amounts of estrogen. The sex hormone has been shown to stimulate the liver to produce higher levels of clotting proteins and may hinder the body’s ability to naturally break down clots.
‘Hormonal contraceptives are an important consideration [for stroke risk],’ Rajagopalan said.
‘Estrogen-containing formulations are traditionally more clearly associated with increased thrombotic risk. Progesterone-only formulations are generally safer, but are not entirely without risk, especially in individuals with underlying predispositions to clotting.
‘These agents may increase coagulability [blood clotting] and interact with other risk factors, so their contribution is often part of a broader risk profile rather than a single cause.’
Wilson-Garza has since switched to an intrauterine device (IUD) containing no estrogen and only small amounts of progesterone.
She has now been named one of the American Heart Association’s Go Red for Women Class of Survivors, which celebrates young, otherwise healthy women who have survived different types of heart disease and stroke.
‘I’ve had multiple [hospital coworkers] come up to me since that situation and they say, “You make me think twice now and never just, write off a younger person with stroke-related symptoms.”
‘Even though this horrible thing happened, if I can change some of the ways of thinking for other nurses and also doctors, then that within itself is huge,’ Wilson-Garza told the Daily Mail.
‘If a doctor could think of me in the back of their mind when they see a younger person with stroke-related symptoms, they’re going to definitely give them the same care that they gave me, and potentially be able to figure out what’s going on and possibly save their life, too.’
