Abstract

AbstractFour hundred seventy-five patients in a care-oriented Southern stroke center were divided into four groups by occlusive and four groups by hemorrhagic syndromes. For each category, known contributing or aggravating etiologic factors were contrasted. Serious medical complications in patients surviving over 72 hours occurred in 34%, with pneumonitis, seizures, acute brain syndromes, rebleeding of aneurysms, and pulmonary emboli leading the list. Almost one third of the 17% fatalities seemed potentially preventable (infections, rebleeds, emboli) with current aggressive therapeutic measures. Forty percent of patients had angiograms, two thirds of which were abnormal. Neck vessel bruits occurred in only 3%. Seven percent required major neurosurgical procedures, but only 1% required neck vessel operation. Far fewer stroke cases from this region require vascular operation than patients from elsewhere in this country. Surgical lesions not suspected by the admitting physician occurred in only 3%; thus, a careful neurologic evaluation appears to be reliable in selecting surgical candidates.