CHRONOBIOLOGICAL PATTERNS OF ONSET OF ACUTE CEREBROVASCULAR DISEASES

There is a considerable amount of data indicating that several major u nfavorable cerebrovascular events are not randomly distributed over ti me, but show a peculiar distribution along the day, the week, and the months of the year. The authors review the available evidence on the c hronobiological (circadian, weekly, and seasonal) patterns of onset of acute cerebrovascular diseases and variations in their possible trigg ering mechanisms. The existence of a peculiar chronobiological pattern in the onset of acute cerebrovascular disease, characterized by both circadian (morning and evening occurrence), circaseptan (last and firs t days of the week), and circannual (especially in winter) is confirme d, although differences depending on biological (gender, age), patholo gical (diabetes, hypertension, smoke, alcohol), cultural, social, and environmental factors exist. A deeper knowledge of the underlying path ophysiologic mechanisms could provide more effective insights for both preventive strategies and optimization of therapeutic approach. (C) 1 998 Elsevier Science Ltd.