Etiology of cerebrovascular accidents in octogenarians.
Stroke is the third leading cause of death in the United States, after coronary heart disease and cancer. Many survivors are left with mental and physical impairment and require assistance with activities of daily living. Twenty-eight percent of patients with stroke are under 65 years of age. We analyzed retrospectively 213 elderly patients with the diagnosis of ischemic cerebrovascular event that were consecutively admitted to the stroke unit of our institution between January 2002 and December 2004. Patient age varied from 65 to 100 years (mean = 79.8 years), and there were 66.19% females and 33.81% males. We analyzed the head CT findings of all the patients and separated the patients into two groups based on the results. Patients in Group I had large infarcts on CT and extensive neurological deficits, while patients in Group II had small lacunar infarcts and minor neurological findings. The charts of all the patients were reviewed retrospectively and data on hypertension, diabetes mellitus, carotid stenosis, atrial fibrillation, left ventricular hypertrophy and anticoagulation were retrieved and analyzed. Our results showed that 35.6% (76) of the patients suffered a major stroke (Group 1) and the remainder 64.4% (137) suffered small lacunar strokes (Group 2). More than half (57.9%) of the patients in Group I were found to have atrial fibrillation and significant carotid stenosis (35.5%) and 22.4%), respectively. The remaining patients (28) were hypertensive and 12% had diabetes mellitus, but no extracerebral source of embolism was found. In Group II, only 13.1% were found to have atrial fibrillation or significant carotid stenosis, but all were hypertensive and 86% suffered from diabetes. Our results indicate that major strokes are less prevalent in the geriatric population than small lacunar strokes and tend to be more related to hypertension and diabetes.
Polena
Sotir
S
Flushing Hospital Medical Center, NY, USA.
Mamakos
Eirene
E
Garewal
Veenu
V
Sharma
Hita
H
Flores
Lucio
L
Seifen
Gerges
G
Gintautas
Jonas
J
Maniar
Rajen
R
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over / Q000502:physiology*; D002544:Cerebral Infarction / Q000150:complications; D048909:Diabetes Complications / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*