Differences in characteristics between patients from Egypt and Germany presenting with lacunar stroke

Area of Science:

• Neurology
• Vascular Neurology
• Epidemiology

Background:

• Lacunar stroke poses a significant health burden globally.
• Data comparing lacunar stroke characteristics between low- and middle-income countries (LMICs) and high-income countries (HICs) are limited.
• Understanding these differences is crucial for effective global management strategies.

Purpose of the Study:

• To investigate and compare the characteristics and vascular status of lacunar stroke patients from Egypt (LMIC) and Germany (HIC).
• To identify demographic, clinical, and neuroimaging variations between the two cohorts.
• To inform potential regional tailoring of lacunar stroke management guidelines.

Main Methods:

• Retrospective analysis of two lacunar stroke patient cohorts from Egypt and Germany (January 2019 - December 2020).
• Data collected included demographics, risk factors, presentation, neuroimaging (MRI, MR/CT angiography), treatment, and outcomes.
• Statistical comparison of variables between the Egyptian and German cohorts.

Main Results:

• MRI revealed distinct lacunar stroke distribution: posterior circulation predominant in Egypt, anterior circulation in Germany.
• Egyptian patients showed a significantly higher proportion of intracranial and combined arterial stenosis.
• Younger age, higher NIHSS, and posterior circulation infarction predicted Egyptian origin; hypertension predicted German origin.

Conclusions:

• Significant clinical and neuroimaging phenotype variations exist in lacunar stroke patients across different geographical regions and populations.
• Differences in arterial stenosis suggest varying underlying pathological processes.
• Lacunar stroke management guidelines may require regional tailoring to address these observed disparities.