The results of a prospective population study of stroke in Tilburg are reported. The average annual over-all incidence (per 100,000 population) for the period October 1, 1978-September 30, 1980 was 174 for total cases, 145 for first-ever cases. Males and older persons were at greater risk for a stroke. The vast majority of strokes were thrombo-embolic infarctions. Hemiplegia was the predominant neurological deficit resulting from an insult. Patients with speech problems, as opposed to those without, demonstrated more extreme motor deficit when such occurred. Seventy-four per cent of stroke cases had hypertensive blood pressure readings shortly after onset. Most patients were under hospital care during the initial phase of their attacks. The presence of such handling was related to specific patient characteristics. Three-week stroke case fatality was 30% for all patients registered, and varied significantly by age, sex and diagnostic type.

No abstract

By means of a case-control study conducted between October 1, 1978, and July 31, 1981, in Tilburg, The Netherlands, various characteristics and events, including personal data, health-related behavior, and medical history, were evaluated as risk factors for stroke. The study subjects included 132 stroke patients and 239 age- and sex-matched control patients interviewed at the two city hospitals. To assess joint effects and possible interactions, and to control for multiple confounding factors, a series of multivariate logistic models for matched data were studied. From this analysis, it appeared that hypertension, acute myocardial infarction, cardiac arrhythmias, transient cerebral ischemic attacks, obesity, physical activity during leisure time, education of head of household, and Rhesus factor were all significant stroke risk factors. These risk determinants demonstrated a multiplicative effect in general; however, the influence of some variables on stroke risk was not constant with age (hypertension, acute myocardial infarction, cardiac arrhythmias, obesity, and Rhesus factor) and sex (hypertension and education of head of household). The relationship of diabetes mellitus to stroke slightly decreased and became nonsignificant after adjustment for factors besides age and sex. Stroke risk was not associated with cigarette and alcohol use, family history of stroke and related disorders, marital status, and ABO blood typing.

We present three obese patients with symptomatic lumbar epidural lipomatosis. All three were treated with a calorie-controlled diet and considerable weight reduction was achieved. MRI demonstrated a reduction in the epidural fat and relief of thecal sac compression in all three; two also improved clinically.

We present three obese patients with symptomatic lumbar epidural lipomatosis. All three were treated with a calorie-controlled diet and considerable weight reduction was achieved. MRI demonstrated a reduction in the epidural fat and relief of thecal sac compression in all three; two also improved clinically.