Southern Buenos Aires stroke project.
BACKGROUND
Ethnic differences and vascular risk factors are the major determinants of stroke subtypes. Nevertheless, specific data from undeveloped countries is difficult to obtain. Natives from South America may have a higher frequency of penetrating small vessel disease and hemorrhagic stroke. However, there are few studies in South America supporting these findings.


OBJECTIVE
We analyze demographic, ethnic, risk factors, clinical characteristics, and stroke subtypes in all patients with acute stroke admitted to our hospital.


METHODS
We studied all consecutive acute stroke patients admitted to the Ramos Mejia Hospital in Buenos Aires from 1997 to 1999. Our hospital serves a determined population of Southern Buenos Aires. Data were collected prospectively on patients' admission in a form especially designed for this study including vascular risk factors, clinical features, epidemiological characteristics, and neuroradiological findings. Stroke subtypes were determined according to the TOAST classification.


RESULTS
Among 361 acute stroke patients, 31% had hemorrhagic stroke. It was more frequent among Natives (34%) than Caucasians (27%) (P<0.002). Ischemic stroke subtypes were as follows: 105 (42%) patients had lacunar, 31 (12%) atherosclerotic stroke, 53 (21%) cardioembolic infarction, and 16 (6%) other causes of stroke. Forty-five (18%) patients were classified as undetermined. Small vessel disease was higher among Caucasians (35%) than Natives (24%).


CONCLUSIONS
Penetrating artery disease (42%) and intracranial hemorrhage (31%) were the most common stroke subtypes, being more frequent than reported in the literature. Natives had significantly higher frequency of hemorrhagic stroke than Caucasians.
Saposnik
G
G
Department of Neurology, Ramos Mejia Hospital, Buenos Aires (1221), Argentina. gsaposnik@yahoo.com
Gonzalez
L
L
Lepera
S
S
Luraschi
A
A
Sica
R E
RE
Caplan
L R
LR
Rey
R C
RC
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001118:Argentina; D001208:Asia / Q000208:ethnology; D002543:Cerebral Hemorrhage / Q000208:ethnology / Q000209:etiology; D002544:Cerebral Infarction / Q000208:ethnology / Q000209:etiology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007199:Indians, South American; D002537:Intracranial Arteriosclerosis / Q000208:ethnology / Q000209:etiology; D020766:Intracranial Embolism / Q000208:ethnology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology* / Q000209:etiology; D014505:Urban Population / Q000706:statistics & numerical data*; D044465:White People