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PubMed1987

The incidence and prognosis of cerebrovascular disease in hospital patients in Helsinki, Finland, in the decade 1970-1980.

Over 21,000 hospital episodes due to cerebrovascular disease (CVD, ICD-8 nos. 430-438) were registered in the Helsinki hospitals in 1970-1980. Of those 17,629 were identified as new cases. The age-adjusted incidence of haemorrhagic and thrombotic stroke (430-433) declined during the period 1970-1975 from 221 to 139 cases/100,000 inhabitants, whereafter no further decrease was observed. The decline in incidence was significant in both sexes. Analysis by diagnosis group showed that the decrease was confined to the incidence of haemorrhagic stroke (430-432), whereas the incidence of thromboembolic stroke (433, 434) and transient ischaemic attacks (435) remained virtually unchanged. Survival was mainly determined by patient age and type of CVD. Intracerebral haemorrhage and occlusion of precerebral arteries exhibited the poorest short-term prognosis. About half of the patients hospitalised due to cerebral thrombosis and embolism survived over one year. Long-term prognosis of the major CVD groups was very poor with only 10% of the patients alive after eight years. Transient cerebral ischaemia and subarachnoid haemorrhage had a clearly better prognosis, the survival rates after eight years being 45 and 30%, respectively.

Adult↗
PubMed1966

The epidemiology of cerebral vascular disease in Canada: an analysis of mortality data.

Mortality data for cerebral vascular disease in Canada and its provinces were analysed as an initial approach to the understanding of the epidemiology of this disease. Since 1950, there has been a decline in mortality attributed to vascular lesions of the central nervous system. This decline has been more pronounced in females. Five-year average age-sex-specific rates (1960-64) showed an almost constant proportional increase with age. The highest mortality rates tended to occur in the Eastern Provinces.From 1950 to 1964 there was a 21% decline in mortality due to intracranial hemorrhage and a concomitant 53% decline in mortality attributed to hypertensive disease. Over the same period there was a 24% increase in mortality attributed to cerebral embolism and thrombosis, and an 8% increase in mortality due to arteriosclerotic heart disease. Areal correlations offered only inconsistent support for the hypothesis that these associated trends are due to common etiologic determinants.Evidence presently available does little to clarify to what extent these trends and differences can be attributed to coding, certification and diagnostic practices, and to what extent to changing and differing incidence and prognosis.

Adult↗
PubMedDate not supplied

Is occult atrial disorder a frequent cause of non-hemorrhagic stroke? Long-term ECG in 86 patients.

To assess the importance of occult atrial disorder with possible embolization as a cause of non-hemorrhagic stroke, 68 patients with neurologic symptoms lasting 24 hours or more and 18 patients with transient ischemic attacks were examined by long-term electrocardiographic recording (LTER). Lacking matched controls we used a reference population of 103 elderly subjects selected at random from the general population for a previous LTER study. Permanent or episodic atrial arrhythmias of types known to cause cerebral embolization were detected by LTER in 32 (47%) of the 68 patients with a clinical diagnosis of cerebral embolization or thrombosis and in 6 (33%) of the 18 patients with transient ischemic attacks. Of the 38 patients with atrial arrhythmia during LTER 17 had such arrhythmias in their standard ECGs. This frequency of atrial arrhythmias during LTER differs from that of the reference population (p less than 0.025). Thirteen of 16 patients with multiple cerebral lesions had signs of atrial arrhythmia during LTER. Patients having occult atrial disorder with episodic atrial arrhythmia may be an important and common risk group for non-hemorrhagic stroke in addition to the previously recognized group of patients with atrial arrhythmia detectable in the standard ECG. LTER may be important in the evaluation of patients with unexplained stroke.

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