Changes in cerebral apoplexy. From 1921 autopsy casses of stroke in 20 years / 日本農村医学会雑誌

ABSTRACT

Purpose: The number of autopsy cases at our department of internal medicine for 20 years from September 1966 reached 1, 921. The autopsy rate stood at 91%. Of them, cases with stroke accounted for 1, 119 (59%). Taking up cerebral infarction and cerebral hemorrhage, we studied changes in type and risk factors for cerebral infarction.<BR>Findings Those subjected to autopsy for stroke included 565 persons with cerebral infarction, 396 with cerebral hemorrhage and 158 with subarachnoid hemorrhage, but those with myocardial infarction accounted for only 107 (5%). In recent years, there has been an increasingly high incidence among old people, In the age group of 70 and over, cerebral infarction accounts for 65-70%, myocardial infarction 61-68% and cerebral hemorrhage 43-49%.<BR>When the period is divided into the first and second halves, and the patients into the age group of 60 and over and the younger group to check changes in the prevalence of cerebral infarction and cerebral hemorrhage, it follows that the prevalence of cerebral infarction has been higher that than of cerebral hemorrhage in recent years, because the incidence of cerebral infarction in the age group of 60 and over has increased.<BR>When the changes are analyzed with cerebral infarction and small infarction, we learn that the increase in the number of cases with infarction is ascribable to a rise in that of cases with large infarction or cortical branches. A check of the relationship between large infarction, atrial fibrillation and valvular disease reveals that tce increase in the incidence of large infarction stems from the infarction of old people afflicted with atrial fibrillation. A check of the relationshdp between the infarction of old people and hypertension and cholesterol indicates that the infarction is closely tied in with hypertension in past history and less correlated to hypercholesteremia. There still are fewer cases with infarction correlated to hyperlipemia than in the Western countries. For its prevention, it is important to control hypertension.