title: Characterization of incident stroke signs and symptoms: findings from the atherosclerosis risk in communities study.
abstract: OBJECTIVE
  Although patterns of stroke occurrence and mortality have been well studied, few epidemiological data are available regarding the clinical characteristics of stroke events.
  
  
  METHODS
  We evaluated hospitalized stroke events reported in the Atherosclerosis Risk in Communities (ARIC) Study to describe the clinical characteristics of incident stroke. Confirmed stroke cases (n=474) were evaluated for stroke symptoms (headache, vertigo, gait disturbance, convulsions) and stroke signs (hemianopia, diplopia, speech deficits, paresis, paresthesia/sensory deficits) and their univariate associations with race, sex, and stroke subtype.
  
  
  RESULTS
  Over 9.2 years of follow-up, 402 (85%) ischemic and 72 (15%) hemorrhagic strokes occurred. Frequency of stroke symptoms (95% CIs) were as follows: headache (27.4%; 23.4% to 31.4%), gait disturbance (10.8%; 7.9% to 13.6%), convulsions (4.4%; 2.6% to 6.3%), and vertigo (2.1%; 0.8% to 3.4%). Speech deficits occurred in 24.0% (20.2% to 27.9%), hemianopia in 14.6% (11.4% to 17.7%), and diplopia in 5.5% (3.4% to 7.5%) of cases. Most cases involved paresis (81.6%; 78.1% to 85.1%), while fewer cases experienced sensory deficits (44.5%; 40.0% to 49.0%). Blacks were more likely than whites to experience paresis (85.4% versus 78.2%; P=0.044). Men were more likely than women to experience a gait disturbance (14.4% versus 6.7%; P=0.007). Persons with hemorrhagic strokes had a higher proportion of headaches (55.6% versus 22.4%; P=0.001) and convulsions (11.1% versus 3.2%; P=0.003) than those with ischemic events, while speech and sensory deficits were more common in ischemic strokes (26.1% versus 12.5%, P=0.013, and 49.0% versus 19.4%, P=0.001, respectively).
  
  
  CONCLUSIONS
  We present epidemiological data concerning the clinical characteristics of incident stroke in a population-based cohort. Although minor differences by race, sex, and stroke subtype were observed, data from additional follow-up are required to confirm observed variations.
authors.affiliation: Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn, USA.
authors.forename: Saif S
authors.initials: SS
authors.lastname: Rathore
authors.forename: Albert R
authors.initials: AR
authors.lastname: Hinn
authors.forename: Lawton S
authors.initials: LS
authors.lastname: Cooper
authors.forename: Herman A
authors.initials: HA
authors.lastname: Tyroler
authors.forename: Wayne D
authors.initials: WD
authors.lastname: Rosamond
mesh_terms: D001161:Arteriosclerosis / Q000453:epidemiology*; D044383:Black People; D002545:Brain Ischemia / Q000175:diagnosis / Q000453:epidemiology; D015984:Causality; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000453:epidemiology; D006261:Headache / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000453:epidemiology; D012306:Risk; D012640:Seizures / Q000453:epidemiology; D012737:Sex Factors; D013064:Speech Disorders / Q000453:epidemiology; D020521:Stroke / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014717:Vertigo / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology; D044465:White People; D001741:Black or African American