study of cerebrovascular disease in middle age Egyptian patients

ABSTRACT

Six probable etiologic factors were determined regarding cerebral infarction. Nine cases [47.4%] had presumed atherosclerosis. Cardiac disease was present in seven cases [36.8%]; two cases had non valvular atrial fibrillation and five patients had rheumatic valvular heart disease. Vasculopathies other than atherosclerosis were responsible in two cases [10.5%]; one of them showed a complication of meningococcal meningitis and the other one was secondary to systemic lupus erythematosus. Oral contraceptive pills were found to be the only possible etiology in one female [5.3%]. Hypertension was the probable cause of hemorrhagic stroke in 23 cases [71.9%]. It was primary hypertension in 18 cases and secondary hypertension in 5 cases. Other etiologies included ruptured vascular malformations in five cases [15.6%], ruptured aneurysms in three cases [9.4%], and bleeding disorder in one case [3.1%]. Cerebral hemorrhage was subarachnoid in four patients [12.5%], ventricular in five patients [15.6%], basal ganglionic capsular in seventeen cases [53.1%], and lobar in six cases [18.8%]. The death rate in cerebral hemorrhage [40.6%] was significantly higher than the death rate in cerebral ischemia [5.3%]. Factors related to prognosis including mass effect, site and size of hematoma as well as the presence of ventricular extension were discussed