STROKE IN A SAUDI-ARABIAN NATIONAL GUARD COMMUNITY - ANALYSIS OF 500 CONSECUTIVE CASES FROM A POPULATION-BASED HOSPITAL

Background and Purpose: We sought to determine the crude incidence rat e, patterns, and risk factors associated with different types of strok e in a defined Saudi population. Methods: Records of 500 (342 male, 15 8 female) consecutive patients with first-ever stroke admitted from De cember 1982 to June 1992 in a hospital that exclusively serves the Sau di Arabian National Guard community were reviewed. Diagnosis was confi rmed by brain computed tomography, and the most likely etiology was de termined on the basis of relevant clinical, radiological, and laborato ry data. Results: The mean age of the patients was 63+/-17 years. Male s predominated in all types of stroke (P<.001). The crude annual incid ence rate was 43.8 per 100 000. Ischemic strokes accounted for 76.2%, and these included 52% with large and 24.2% with lacunar infarctions. Intracerebral hemorrhage was detected in 21.4%, whereas subarachnoid h emorrhage was rare (2.4%). Hypertension (56%), diabetes mellitus (42%) , and cardiopathy (33%) were common risk factors. Sixty-one patients ( 12%) died during the first month after their stroke. Conclusions: The study suggests that stroke incidence is low in Saudi Arabia compared w ith industrialized countries, which could be because of the predominan ce of young age groups. The overall distribution of stroke types was c loser to that of Western populations than to the Japanese, in whom hem orrhagic strokes are highly prevalent. However, the high combined freq uencies of lacunar infarctions and intracerebral hemorrhages suggest t hat disease of the small cerebral arteries played a more important rol e in Saudis than in Western populations.