title: Two-peak temporal distribution of stroke onset in Greek patients. a hospital-based study.
abstract: A circadian distribution with a single peak of stroke onset in the morning hours has been described in various countries. Analysis of the temporal pattern of symptom onset in a series of 1253 Greek first-ever stroke patients revealed a circadian distribution with two incidence peaks between 08.00 and 10.00 h, and between 16.00 and 18.00 h. Considering the different etiopathogenic types of stroke, the same two-peak time pattern was evaluated in all stroke subgroups with the only exception of lacunar stroke, which seems to predominantly occur during night and sleep. A secondary stroke onset peak in the late afternoon has not been previously described in such detail. A relation between the second, however lower, frequency peak and the traditional Greek habit of afternoon sleep (siesta) could be assumed and deserves further investigation.
authors.affiliation: Department of Neurology, University of Athens School of Medicine, 'Eginition' Hospital, Athens, Greece. spengos@hol.gr
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Spengos
authors.forename: Kostas N
authors.initials: KN
authors.lastname: Vemmos
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsivgoulis
authors.forename: Andreas
authors.initials: A
authors.lastname: Synetos
authors.forename: Nikolaos A
authors.initials: NA
authors.lastname: Zakopoulos
authors.forename: Vassilios  P
authors.initials: V
authors.lastname: Zis
authors.forename: Demitris
authors.initials: D
authors.lastname: Vassilopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002940:Circadian Rhythm / Q000502:physiology*; D019317:Evidence-Based Medicine; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D002537:Intracranial Arteriosclerosis / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D020300:Intracranial Hemorrhages / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D013997:Time Factors