Shiao-Lin Lai

Background and Purpose: Stroke risk factors and subtypes were examined for associations with mortality and recurrence rate in Taiwanese patients with first-ever and recurrent stroke. Methods: This study examined patients with initial and recurrent stroke from 2003 to 2005 for risk factors, demographic data, Bamford subtypes and transient ischemic attack. Results: One thousand and twenty-one patients with 1,085 stroke episodes were recruited. Significant factors associated with recurrent stroke were hyperlipidemia, atrial fibrillation and smoking. A significant incidence of lacunar infarction was noted in the patient population (37.82% in all patients; 41.02% in first stroke vs. 35.67% in recurrent stroke patients). Patients with diabetes mellitus were more likely to have lacunar rather than total anterior circulation infarction (TACI) or partial anterior circulation infarction (PACI). Hyperlipidemia was more often attributable to lacunar stroke than PACI. Atrial fibrillation was significantly associated with nonlacunar infarcts, TACI and PACI but not lacunar stroke. Conclusions: The incidence of lacunar infarction was significantly higher in initial rather than recurrent stroke patients. Diabetes mellitus or hyperlipidemia was highly associated with lacunar infarction. Atrial fibrillation was associated with nonlacunar infarction in Taiwan, similar to the result of White and Black populations in the UK.

Few studies have addressed intracerebral hemorrhage (ICH) in younger adults. We studied spontaneous ICH in adults ≤45 years of age. We retrospectively reviewed patients hospitalized with ICH between 2000 and 2001 to investigate incidence, etiology, risk factors, bleeding sites, management, and prognosis. Patients (224 men, 72 women; 37.0 ± 7.7 years) had a mortality rate of 24%. The most common risk factor for mortality was hypertension (HTN) (48.7%). Bleeding was most common in the ganglion (49.0%). Multiple hemorrhages (83.3%) caused the highest mortality, with the most common cause of mortality being HTN (46.6%). Coagulopathy (62.5%) caused the highest mortality based on etiologic classification. Recurrent HTN‐induced hemorrhage rate was 3.6%. In Taiwanese adults ≤45 years of age, ICHs mainly involve the ganglion and result from HTN. Rates of HTN‐induced hemorrhage are higher in Taiwan (46.6%) than elsewhere. Differences between races or countries should be investigated further.