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Cerebrovascular disease cases in Budapest showed more cerebral thromboses and fewer cerebral hemorrhages than international data. Hospitalized patients, however, had more cerebral hemorrhages, suggesting diagnostic discrepancies in community-based studies.
Area of Science:
- Neurology
- Epidemiology
- Pathology
Background:
- Cerebrovascular diseases represent a significant global health burden.
- Understanding regional variations in disease patterns is crucial for public health.
- Previous studies suggested specific incidence rates for cerebral thrombosis and hemorrhage.
Purpose of the Study:
- To analyze the clinical manifestations and outcomes of cerebrovascular diseases in Budapest's 7th District from 1970-1976.
- To compare local epidemiological data with international literature.
- To investigate potential discrepancies between community and hospital-based diagnoses.
Main Methods:
- Retrospective analysis of 1550 registered cases of cerebrovascular diseases.
- Follow-up of patient outcomes from 1981-1985.
- Inclusion of hospital-treated patients for comparative analysis.
- Review of autopsy results for deceased hospitalized patients.
Main Results:
- A higher incidence of cerebral thromboses and a lower incidence of cerebral hemorrhages were observed in the general population compared to international data.
- Hospitalized patients exhibited a higher frequency of cerebral hemorrhages than initially registered in the community.
- Autopsy findings confirmed clinical diagnoses and revealed severe arteriosclerosis, with no difference in severity between cerebrovascular disease patients and those with heart disease, but a notable difference in carcinoma patients.
Conclusions:
- Community-based data on cerebrovascular diseases may underestimate cerebral hemorrhages.
- Hospital data provides a more accurate reflection of certain cerebrovascular disease patterns.
- Severe arteriosclerosis is a common finding in cerebrovascular disease patients, with varying prevalence in relation to other major diseases.
Abstract:
The clinical manifestations of cerebrovascular diseases observed in the 7th District of Budapest between 1970 and 1976 were analyzed and the patients' further fate followed up between 1981 and 1985. It could be stated that out of the total of 1550 cases of cerebrovascular diseases registered the number of cerebral thromboses was essentially higher and that of cerebral haemorrhage markedly lower as compared to data given in the international literature. Therefore, patients with cerebrovascular diseases treated in the hospital of the 7th District were also included in the analysis. Results showed cerebral haemorrhages to occur more frequently as compared to the number of those treated in the territory; the number of thromboses was also significantly higher in these clinical patients as compared to international data. For the purpose of a more precise diagnosis the autopsy results of patients with cerebrovascular diseases who were treated and died in hospital were also reviewed. The thrombosis-cerebral haemorrhage ratio corroborated the clinically established diagnostic results. Autopsy results revealed the existence of a severe arteriosclerosis. The degree of severity in patients with a cerebrovascular disease revealed no difference as compared to other patients who died primarily because of heart diseases. It showed, however, a pronounced deviation in patients who died because of carcinoma. A more detailed investigation of these findings will be a future task.