Brainin M
Institut zur Erforschung und Verhütung des Schlaganfalls, NO. wissenschaftlichen Landesakademie.
Nervenarzt. 1990 Dec;61(12):719-24.
Most classifications of stroke include clinically heterogeneous subgroups and therefore are of limited value for comparative studies or clinical protocols. The view is held that a classification according to stroke etiology is clinically more reasonable and more consistent for therapeutic strategies. In order to determine the frequency of various etiological subgroups in a series of stroke cases, the results of the Klosterneuburger Schlaganfall-Datenbank (KSDB) are reported. This stroke registry has prospectively recorded over 300 items on all stroke cases referred to one center since March 1988. Investigation rates include CT in almost 100% and the investigation of cerebral vessels in over 90% of all cases. By applying defined etiological categories (undetermined etiology, atherosclerosis of the large craniocervical vessels, cardiogenic embolism, lacunar, primary hemorrhage, and multiple and other causes) to the first 420 patients registered within the first two years it can be shown that even with CT and neurosonology in routine use, in 29% of all cases the cause of the stroke cannot be determined. To investigate this largest subgroup by means of additional new methods as well as by investigating the long-term natural course represents an important challenge for clinical stroke research.
大多数中风分类都包含临床异质性亚组,因此对于比较研究或临床方案的价值有限。有一种观点认为,根据中风病因进行分类在临床上更合理,且在治疗策略上更具一致性。为了确定一系列中风病例中各种病因亚组的发生率,本文报告了克洛斯特新堡中风数据库(KSDB)的结果。自1988年3月以来,该中风登记处前瞻性地记录了转诊至一个中心的所有中风病例的300多项信息。检查率包括几乎100%的CT检查以及超过90%的所有病例的脑血管检查。通过将定义的病因类别(病因不明、颅颈大血管动脉粥样硬化、心源性栓塞、腔隙性、原发性出血以及多种其他原因)应用于头两年内登记的前420例患者,可以发现,即使常规使用CT和神经超声检查,在所有病例中仍有29%的中风病因无法确定。通过额外的新方法以及对长期自然病程进行研究来调查这个最大的亚组,是临床中风研究面临的一项重要挑战。