The Athens Stroke Registry: Results of a Five-Year Hospital-Based Study

Abstract

The advent and wide application of new technology, especially noninvasive techniques, has enabled physicians to more completely investigate and clarify the etiopathogenic mechanisms of stroke. Such data have not been available until recently for Southeastern Europe. In addition, during the last decades, strategies for the modification of risk factors and primary prevention may have changed the prevalence of each subgroup of stroke as well. We investigated 1,042 consecutive patients who had first strokes, during a period of 5 years (from June 1992 to May 1997) and classified them prospectively based on etiopathogenic mechanisms. Patients with transient ischemic attacks and subarachnoid hemorrhage were excluded. There were 613 male and 429 female patients, with a mean age of 70.2 ± 11.9 years. Forty-six percent of the patients arrived within 3 h from stroke onset. The probable mechanisms were: large-artery atherosclerosis, 156 (15%); lacunes, 177 (17%); cardioembolic, 335 (32.1%); infarct of unknown cause, 182 (17.5%); miscellaneous causes, 35 (3.3%), and intracerebral hemorrhage (ICH), 157 (15.1%). In the cardioembolic group, nonvalvular atrial fibrillation (NVAF) was the probable cause in 225 patients, especially in patients older than 75 years (65%). The overall hospital mortality was 15.2% (from 0.6% for lacunar stroke to 34% for ICH). In our population, cardioembolism is the most frequent subtype of stroke. NVAF is the most likely source, especially in older patients.

Association of a higher density of specialist neuroscience providers with fewer deaths from stroke in the United States population

“…[3][4][5]17,22,23,26,35 The incidence of stroke is estimated at 750,000 cases per year, and has been steadily increasing. 29 A wide variability of stroke prevalence and stroke-related mortality has been observed in different countries, in different states of the US, and even in different counties of the same state.…”

Long-Term Prognosis of Acute Kidney Injury after First Acute Stroke

“…Patients with subarachnoid hemorrhage were transferred to a neurosurgical unit. All patients were investigated prospectively on the basis of a standard diagnostic protocol, and the data were entered into a computerized stroke data bank (10). For the purpose of this study, we selected 2155 patients who presented within 24 h from symptom onset and had renal function tests both on admission and within the first 48 h. A total of 443 patients were excluded from the study because of delay of admission (n ϭ 251), lack of neurologic evaluation (n ϭ 145), and missing values concerning renal function tests (n ϭ 47).…”

Factors influencing acute blood pressure values in stroke subtypes

“…Details of this study and exclusion criteria (transient ischaemic attacks, age below 18, recurrent stroke and subarachnoid haemorrhage) have been published elsewhere. 20 On admission, an internist specialised in stroke or a neurologist examined all patients, and assessed stroke severity using the Scandinavian Stroke Scale (SSS). 21 This scale evaluates the level of consciousness, eye movement, motor power in the hand, arm and leg, orientation and aphasia, facial paresis and gait.…”

“…The diagnosis of intracerebral haemorrhage (ICH) was made when hyperdense lesions were identified on admission CT scan in one of five following territories: lobar, lenticulocapsular, thalamic, cerebellar or brainstem. 20 Risk factors, such as history of hypertension, atrial fibrillation, coronary artery disease, heart failure, cigarette smoking, diabetes mellitus and hypercholesterolaemia were documented. 20 Patients were diagnosed as having a history of hypertension, if they had evidence of systolic blood pressure (SBP) above 140 mmHg or diastolic blood pressure (DBP) above 90 mmHg at any time before or 4 weeks after stroke onset or if they were receiving antihypertensive medication before the index event.…”