Stroke in Jerusalem District 1960 Through 1967: An Epidemiological Study

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Abstract
An epidemiological study was performed in Jerusalem district on the incidence of new stroke patients during the years 1960 through 1967. On the assumption that the vast majority of patients with a new cerebrovascular event were either hospitalized in one of the three local hospitals or later referred to the Neurological Outpatient Clinic at the Hadassah University Hospital, a retrospective study was performed in order to obtain a close estimation of the incidence of stroke in the district of Jerusalem. In the period of 1960 through 1967, 1,522 new stroke cases were identified and included in this study. On the basis of the history, clinical picture and auxiliary tests, the patients were divided into three groups: (1) ischemic stroke, (2) stroke due to hemorrhage, and (3) stroke of undetermined type. The criteria for differentiation of cerebral ischemia from hemorrhage were rigid, demanding at least a lumbar puncture, angiography, operation, or autopsy for a diagnosis of either one to be made. These rigid criteria account for the high percentage of undetermined cases. Ischemic stroke was diagnosed in 509 (33%), stroke due to hemorrhage in 181 (12%), and stroke of undetermined type in 832 (55%). The average annual incidence of stroke in the district of Jerusalem was 90/100,000 population. The age-specific annual incidence rates showed an almost constant increase for both sexes and the various types of stroke, with increasing age. The age-specific and sexspecific annual incidence rates disclosed a male preponderance for all the age groups above 45 in the "ischemic" and "undetermined" types, and for the total series. This preponderance was marked in the 65 to 74 age group. In the "stroke due to hemorrhage" type there was a slight male preponderance in the 65 to 74 age group and a slight female preponderance in the 75+ age group, the ratio being equal for the total hemorrhagic series. Our findings were compared with those reported in other studies and discussed.