Epidemiology of Stroke in Costa Rica: A 7-Year Hospital-Based Acute Stroke Registry of 1319 Consecutive Patients

Torrealba‐Acosta, Gabriel; Carazo-Céspedes, Kenneth; Chiou, Shyh‐Horng; O’Brien, Anthony Terrence; Fernández-Morales, Huberth

doi:10.1016/j.jstrokecerebrovasdis.2017.11.030

Cited by 10 publications

(6 citation statements)

References 70 publications

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“…Regarding patients’ age, in our study the mean age of our patients was 61.32 ± 4.34 years, these results are in accordance with the work of Torrealba-Acosta et al, 27 who found that an advanced age is a nonmodifiable risk factor for ischemic stroke associated with higher morbidity and mortality rates. On the other hand, these results are not in harmony with the work of Cai et al, 28 who concluded that the age per se is not a bad prognostic factor, but the age-related vascular risks including hypertension, diabetes, and cardiovascular diseases are the cause of poor functional outcome after stroke.…”

Section: Discussionsupporting

confidence: 92%

Prediction of Motor Recovery after Stroke by Assessment of Corticospinal Tract Wallerian Degeneration Using Diffusion Tensor Imaging

Darwish

Elshafey

Kamel

2021

Indian Journal of Radiology and Imaging

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Aim of the Study To predict motor recovery after stroke by detection of diffusion tensor imaging (DTI) fractional anisotropy (FA) changes of corticospinal tract (CST) and correlate findings with clinical scores to provide more effective treatment and rehabilitation. Subjects and Methods Thirty patients with cerebral stroke were enrolled and underwent conventional magnetic resonance imaging and DTI at admission and 1 month after stroke. Mean diffusivity (MD), FA, FA ratio (rFA), and fiber number (FN) values of CST were calculated at the pons at admission and after 1 month of stroke. Three-dimensional reconstruction of bilateral CST and the structural changes of fibrous bands were observed. Severity of limb weakness was assessed by using the motor sub-index scores of the National Institutes of Health Stroke Scale (NIHSS) at admission, and after 1, 6, and 9 months for severity of limb weakness. Results The mean age of our patients was 61.32 ± 4.34 years, 17/30 (56.6%) were females, and 13/30 (43.4%) were males. In our study, 18/30 (60%) were hypertensive, 19/30 (63.3%) were diabetic, and 12/30 (40%) were smokers. A significant negative correlation was found between rFA and FN in the ipsilateral CST of the cerebral infarction at the rostral part of pons after 1 month of infarction and NIHSS score at 6 months (r = 0.377, p = 0.04 and r = 0.237, p = 0.02, respectively). However, a positive insignificant correlation was found between MD and NIHSS (r = 0.345, p = 0.635). The initial NIHSS score at the time of injury was 19.2 ± 4.3, which changed to 7.9 ± 2.4, 4.6 ± 1.9, and 3.3 ± 1.4 at 1, 6, and 9 months, respectively. Conclusion DTI is a sensitive tool for early detection of Wallerian degeneration in the CST after stroke, and can predict motor performance to provide effective treatment and rehabilitation to improve quality of life.

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Section: Discussionsupporting

confidence: 92%

Prediction of Motor Recovery after Stroke by Assessment of Corticospinal Tract Wallerian Degeneration Using Diffusion Tensor Imaging

Darwish

Elshafey

Kamel

2021

Indian Journal of Radiology and Imaging

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“…Therefore, these two chronic diseases are still the main stroke risk factors, which is consistent with a previous population study conducted in 2008. The high prevalence of hypertension and insufficient control explain the high proportion of hemorrhagic strokes, particularly in younger patients, compared with populations in Europe [ 18 , 19 , 20 ], and Asia [ 21 , 22 ], but with notable similarities when compared with other Latino and Japanese populations [ 23 , 24 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Stroke Care in Mexico City: The Hospital Phase of a Stroke Surveillance Study

et al. 2022

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Background: Acute stroke care has greatly improved in recent decades. However, the increasing stroke mortality in low-to-middle income countries suggests that progress has not been reached completely by these populations. Here we present the analysis of the hospital phase of the first population-based stroke surveillance study. Methods: A daily hospital surveillance method was used to identify adult patients with acute stroke during 18 months in six hospitals. We abstracted data on demographics, vascular risk factors, neuroimaging-confirmed stroke types, and clinical data. Results: A total of 1361 adults with acute stroke were identified (mean age 69.2 years; 52% women) with transient ischemic attack (5.5%), acute ischemic stroke (68.6%), intracerebral hemorrhage (23.1%), cerebral venous thrombosis (0.2%), and undetermined stroke (2.6%). The main risk factors were hypertension (80.7%) and diabetes mellitus (47.6%). The usage rate of thrombolysis was 3.6%, in spite of the fact that 37.2% of acute ischemic stroke patients arrived in <4.5 h. The 30-day case fatality rate was 32.6%, higher in hemorrhagic than ischemic stroke. Conclusion: We identified limitations in acute stroke care in the Mexico City, including neuroimaging availability and thrombolysis usage. The door-to-door phase will help to depict the acute stroke burden in Mexico.

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“…The mechanisms through which smoking affects stroke risk are not fully clear, smoking is likely to contribute to an increased stroke risk through both short-term effect on thrombus generation in atherosclerotic arteries and long-term effect related to the development of atherosclerotic stenosis [4]. Smoking could cause stroke also through reversible factors such as increased platelet aggregation and arterial vasoconstriction by augmenting sympathetic activity, explaining the stroke risk [29]. A 10-year prospective cohort study in China found that smoking could raise the risk of ischemic stroke among hypertensives.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for ischemic stroke: differences between cerebral small vessel and large artery atherosclerosis aetiologies

Shi¹,

Guo²,

Chen³

et al. 2021

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The treatment for large artery atherosclerosis (LAA) stroke is also important for patients with cerebral small vessel disease (SVD). Our aim is to clarify the risk factors for ischemic cerebral SVD and to evaluate the different risk factor profiles of the two ischemic stroke subtypes, namely, ischemic cerebral SVD and LAA. A total of 353 patients with acute ischemic stroke were assigned to two groups according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria: the ischemic cerebral SVD group and the LAA group. A total of 70 non-stroke patients admitted during the same period served as the control group. Clinical variables were collected, including age, sex, blood pressure, blood glucose, triglycerides, low-density lipoprotein, total cholesterol (TC), smoking history, drinking history, coronary atherosclerotic heart disease and family history of a high-risk disease. Multivariate logistic regression (MLR) analyses were performed. MLR analysis showed that risk factors for LAA stroke included hypertension, diabetes mellitus, high low-density lipoprotein, hypertriglyceridemia and smoking compared with the control group. The analysis also showed that the risk factors for cerebral SVD stroke were hypertension, diabetes mellitus, high TC, hypertriglyceridemia and smoking. In terms of the factors distinguishing LAA and cerebral SVD, MLR demonstrated that high TC played prominent roles in cerebral SVD. Hypertension, diabetes mellitus, high total cholesterol, hypertriglyceridemia and smoking are independent risk factors for cerebral SVD stroke. Compared with the LAA stroke group, patients with cerebral SVD stroke were more likely to have a high level of TC.

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Epidemiology of Stroke in Costa Rica: A 7-Year Hospital-Based Acute Stroke Registry of 1319 Consecutive Patients

Cited by 10 publications

References 70 publications

Prediction of Motor Recovery after Stroke by Assessment of Corticospinal Tract Wallerian Degeneration Using Diffusion Tensor Imaging

Prediction of Motor Recovery after Stroke by Assessment of Corticospinal Tract Wallerian Degeneration Using Diffusion Tensor Imaging

Acute Stroke Care in Mexico City: The Hospital Phase of a Stroke Surveillance Study

Risk factors for ischemic stroke: differences between cerebral small vessel and large artery atherosclerosis aetiologies

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