Characterization of incident stroke signs and symptoms: findings from the atherosclerosis risk in communities study

Stroke. 2002 Nov;33(11):2718-21. doi: 10.1161/01.str.0000035286.87503.31.

Abstract

Background and purpose: Although patterns of stroke occurrence and mortality have been well studied, few epidemiological data are available regarding the clinical characteristics of stroke events.

Methods: We evaluated hospitalized stroke events reported in the Atherosclerosis Risk in Communities (ARIC) Study to describe the clinical characteristics of incident stroke. Confirmed stroke cases (n=474) were evaluated for stroke symptoms (headache, vertigo, gait disturbance, convulsions) and stroke signs (hemianopia, diplopia, speech deficits, paresis, paresthesia/sensory deficits) and their univariate associations with race, sex, and stroke subtype.

Results: Over 9.2 years of follow-up, 402 (85%) ischemic and 72 (15%) hemorrhagic strokes occurred. Frequency of stroke symptoms (95% CIs) were as follows: headache (27.4%; 23.4% to 31.4%), gait disturbance (10.8%; 7.9% to 13.6%), convulsions (4.4%; 2.6% to 6.3%), and vertigo (2.1%; 0.8% to 3.4%). Speech deficits occurred in 24.0% (20.2% to 27.9%), hemianopia in 14.6% (11.4% to 17.7%), and diplopia in 5.5% (3.4% to 7.5%) of cases. Most cases involved paresis (81.6%; 78.1% to 85.1%), while fewer cases experienced sensory deficits (44.5%; 40.0% to 49.0%). Blacks were more likely than whites to experience paresis (85.4% versus 78.2%; P=0.044). Men were more likely than women to experience a gait disturbance (14.4% versus 6.7%; P=0.007). Persons with hemorrhagic strokes had a higher proportion of headaches (55.6% versus 22.4%; P=0.001) and convulsions (11.1% versus 3.2%; P=0.003) than those with ischemic events, while speech and sensory deficits were more common in ischemic strokes (26.1% versus 12.5%, P=0.013, and 49.0% versus 19.4%, P=0.001, respectively).

Conclusions: We present epidemiological data concerning the clinical characteristics of incident stroke in a population-based cohort. Although minor differences by race, sex, and stroke subtype were observed, data from additional follow-up are required to confirm observed variations.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Arteriosclerosis / epidemiology*
  • Black People
  • Brain Ischemia / diagnosis
  • Brain Ischemia / epidemiology
  • Causality
  • Cerebral Hemorrhage / diagnosis
  • Cerebral Hemorrhage / epidemiology
  • Cohort Studies
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Gait Disorders, Neurologic / epidemiology
  • Headache / epidemiology
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Paresis / epidemiology
  • Risk
  • Seizures / epidemiology
  • Sex Factors
  • Speech Disorders / epidemiology
  • Stroke / classification
  • Stroke / diagnosis*
  • Stroke / epidemiology*
  • United States / epidemiology
  • Vertigo / epidemiology
  • Vision Disorders / epidemiology
  • White People