Cerebrovascular Risk Factors and Stroke Subtypes in Different Age Groups: A Hospital-Based Study
We prospectively studied the characteristics of 401 patients with first-ever-in-a lifetime stroke who have been admitted consecutively into stroke care unit. During the evaluation of distribution according to age, patients were divided into 7 age groups with 10-year intervals. It was determined that ischemic stroke was mostly seen in the age group 71-80 (32.2%) and the age group 61-70(28.2%). The major risk factor of ischemic stroke was hypertension, followed by diabetes mellitus, ischemic heart disease, smoking and hypercholesterolemia. The three most frequent etiologic categories were small-vessel disease, atherosclerotic large vessel disease and cardioembolism. The anatomical distribution of ischemic stroke were made according to the Oxfordshire Community Stroke Project. The distribution of patients in term of vascular territories was most frequently seen in lacunar infarction. It was determined that lacunar infarcts were more significant in males whereas posterior circulation infarcts were more significant in females. When the distribution of vascular territories was evaluated in terms of risk factors, it was seen that hypertension and ischemic heart diseases were significant in total anterior circulation infarcts, and transient ischemic attack was significant in posterior circulation infarcts.
Cerebrovascular Risk Factors and Stroke Subtypes in Different Age Groups: A Hospital-Based Study
We prospectively studied the characteristics of 401 patients with first-ever-in-a lifetime stroke who have been admitted consecutively into stroke care unit. During the evaluation of distribution according to age, patients were divided into 7 age groups with 10-year intervals. It was determined that ischemic stroke was mostly seen in the age group 71-80 (32.2%) and the age group 61-70(28.2%). The major risk factor of ischemic stroke was hypertension, followed by diabetes mellitus, ischemic heart disease, smoking and hypercholesterolemia. The three most frequent etiologic categories were small-vessel disease, atherosclerotic large vessel disease and cardioembolism. The anatomical distribution of ischemic stroke were made according to the Oxfordshire Community Stroke Project. The distribution of patients in term of vascular territories was most frequently seen in lacunar infarction. It was determined that lacunar infarcts were more significant in males whereas posterior circulation infarcts were more significant in females. When the distribution of vascular territories was evaluated in terms of risk factors, it was seen that hypertension and ischemic heart diseases were significant in total anterior circulation infarcts, and transient ischemic attack was significant in posterior circulation infarcts.
___
- Kumral E, Ozkaya B, Sagduyu A et al. The Ege Stroke Registry: A Hospital-Based Study in the Aegean Region, Izmir,Turkey. Cere- brovasc Dis 8: 278-288,1998.
- Gazi Özdemir, Serhat Özkan, Nevzat Uzuner et al. Türk Beyin Damar Hastalıkları Dergisi 6: 31-35, 2000.
- Tanaka H, Hayashi M, Date C et al. Epidemiologic studies of stroke in Shibata, a Japanese provincial city; preliminary report on risk factors for cerebral infarction. Stroke 16:773-778, 1985.
- Bonita R. Epidemiology of stroke. Lancet, 339: 342-344,1992.
- Herman B, Leyten A, Van Lujik JH et al. Epidemiology of stroke in Tilburg, the Netherlands. The population-based stroke register: 2.incidence,initial clinical Picture and medical care, and three- week case fatality. Stroke 13: 629-634, 1982.
- Bogousslavsky J, Van Mele G, Regli F. Middle cerebral artery pial territory infarcts; a study of Lausanne Stroke Registry. Ann Neu- rol 25: 555-560, 1989.
- Mast H, Thompson J, Lee SH et al. Hypertension and Diabetes Mellitus as Determinants of Multiple Lacunar Infarcts. Stroke 26: 30-3, 1995.
- Saposnik G, Caplan LR, et al. Differences in stroke subtypes among native and caucasians in Boston and Buenos Aires. Stroke 31: 2385-89, 2000.
- Tell GS, Crouse JR, Furberg CD. Relation between blood lipids, lipoproteins and cerebrovascular atherosclerosis. A review. Stroke 19: 423-430, 1988.
- Wannamethee SG, Shaper AG, Ebrahim S. HDL-cholesterol, total cholesterol and the risk of stroke in middle-aged British men. Stroke 31: 1882-88, 2000.
- Gorelick PB. The status of alcohol as a risk factor for stroke. Stroke 20:1607-10, 1989
- Love BB, Biller J, Jones MP et al. Cigarette smoking. A risk fac- tor for cerebral infarction in young adults. Arch Neurol 47: 693- 98, 1990.
- Harmsen P, Rosengren A, Tsipogianni A, et al . Risk factors for stroke in middle-aged men in Goteborg, Sweden. Stroke 21: 223-229, 1990.
- Petty GW, Brown RD, Whisnant JP et al. Ischemic stroke sub- types: a population –based study of incidence and risk factors. Stroke 30: 2513-16, 1999.
- Kolominsky-Rabas PL, Weber M, Gefeller O et al. Epidemiology of ischemic stroke subtypes according to TOAST criteria: incidence, recurrence and long-term survival in ischemic stroke subtypes: a population-based study. Stroke 32: 2735-40, 2001.
- Mead GE, Murray H, Farrell A et al. Pilot study of carotid surgery for acute stroke. British Journal of Surgery 84: 99-992, 1997.
- Lindgren A, Roijer A, Norrving B et al. Carotid artery and heart disease in subtypes of cerebral infarction. Stroke 25: 2356-2362, 1994.
- Heinzeus T, Bogousslavsky J, van Mele G. Large infarcts in the middle cerebral artery territory: etiology and outcome patterns. Neurology 50:341-350, 1998.
- Caplan LR, Tettenborn B. Vertebrobasilar occlusive disease- review of selected aspects posterior circulation embolism. Cere- brovasculer Disease 2: 320-326, 1992
- Fisher CM. Capsular infarcts: the underlying vascular lesions. Archives of Neurology 36: 65-73, 1979
- Millikan CH. About lacunes. Lacunar and Other Subcortical Infarc- tion. Eds; Donan GA, Norrving B, Bamford JM, Bogousslavsky J. Oxford Universty Pres, Oxford, 1995, pp: 23-28
- Kappelle LJ, Koudstaal PJ,Van Gijn et al. Carotid angiography in patients with lacunar infarction : a prospective study. Stroke 19:1093- 1096, 1988.