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The MEDUNSA Stroke Data Bank. An analysis of 304 patients seen between 1986 and 1987
1Department of Neurology, Medical University of Southern Africa, Pretoria.
Insights
This study analyzed stroke data in South African Black populations, finding similarities in risk factors like hypertension but differences in stroke types compared to Western data. The MEDUNSA Stroke Data Bank (MSDB) provides crucial insights into cerebrovascular disease in this demographic.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Stroke represents a significant cause of death and disability among Black Africans.
- The MEDUNSA Stroke Data Bank (MSDB) was established in 1984 to collect comprehensive data on cerebrovascular disease in South African Black patients.
- Modern diagnostic tools, including computed tomography (used in 82.2% of cases), support data collection.
Purpose of the Study:
- To gather extensive data on all facets of cerebrovascular disease within the South African Black population.
- To facilitate a deeper understanding of stroke in this demographic.
- To enable comparative studies on atherosclerosis and cerebrovascular disease.
Main Methods:
- Data collection through the MEDUNSA Stroke Data Bank (MSDB).
- Utilisation of modern investigative techniques, notably computed tomography.
- Analysis of patient data to identify stroke types, risk factors, and etiological sources.
Main Results:
- Cerebral infarction was the predominant diagnosis, affecting 71.2% of patients.
- Risk factors such as hypertension and advanced age showed similarities to Western stroke populations.
- A probable or definite cardiac source for cerebral embolism was identified in 46% of patients.
- Transient ischemic attacks, peripheral vascular disease, coronary artery disease, and lacunar strokes were less frequent than in Western cohorts.
Conclusions:
- Hypertension and increasing age are significant stroke risk factors in South African Black individuals, mirroring Western populations.
- Cardiac embolism is a notable cause of stroke in this group.
- Differences in the incidence of certain stroke subtypes suggest unique etiological or epidemiological factors in Black Africans warranting further investigation and comparative studies on atherosclerosis.
Abstract:
Stroke is a major cause of mortality and morbidity in black Africans. The MEDUNSA Stroke Data Bank (MSDB) was established in 1984. Its goal is to gather data on all aspects of cerebrovascular disease in South African blacks, and it is supported by modern investigative techniques such as computed tomography (utilised in 82.2% of cases). The majority of the patients (71.2%) had cerebral infarction. Certain features, such as the importance of hypertension and increasing age as risk factors, were found to be similar to Western stroke populations; also, probable or definite cardiac source for cerebral embolism was present in 46% of the patients. In contrast, however, other features, such as transient ischaemic attacks, peripheral vascular disease, coronary artery disease and lacunar strokes, occurred far less frequently than is reported in Western patients. It is hoped that the MSDB will lead to a better understanding of cerebrovascular disease in blacks and possibly to in-depth comparative studies of the ubiquitous problem of atherosclerosis.