The Harvard Cooperative Stroke Registry: a prospective registry

Area of Science:

• Neurology
• Epidemiology

Background:

• Stroke registries are crucial for understanding disease patterns.
• Previous data relied heavily on postmortem analysis, limiting real-time insights.

Purpose of the Study:

• To prospectively analyze stroke subtypes and their characteristics in hospitalized patients.
• To identify new observations compared to existing stroke registries.

Main Methods:

• Prospective, computer-based registry of 694 hospitalized stroke patients.
• Classification of stroke subtypes: thrombosis, cerebral embolism, intracerebral hematoma, and subarachnoid hemorrhage.
• Sub-classification of thrombosis into large artery involvement and lacunar infarction.

Main Results:

• Thrombosis (53%), cerebral embolism (31%), intracerebral hematoma (10%), and subarachnoid hemorrhage (6%) were the primary diagnoses.
• Large artery thrombosis occurred in 34% and lacunar infarction in 19% of all patients.
• Key new findings include high incidence of lacunes and cerebral emboli, with 37% of emboli lacking a cardiac origin and 21% having a non-sudden onset.

Conclusions:

• Prospective data collection offers valuable insights into stroke epidemiology.
• The study identified a significant incidence of lacunar infarction and cerebral embolism.
• New observations on embolism origin and hematoma presentation provide a more nuanced understanding of stroke pathophysiology.