Type, causes, and prognosis of stroke recurrence in the province of Teruel, Spain. A 5-year analysis

Recurrent strokes are an important cause of morbidity and mortality. Identi fication of the causes of recurrence and its treatment may play an essentia l role in the prevention of further strokes. The aim of our work is to anal yze the type and causes of stroke recurrence in a 5-year period and to dete rmine if recurrent stroke is of the same type as index stroke. In a retrosp ective study, we reviewed the clinical records and database of our hospital s and found a total of 1108 patients admitted because of primary stroke. Th e patients with recurrent stroke were selected for a comprehensive analysis . Age, vascular risk factors and fatality rates of these patients were comp ared with those obtained in recurrence-free patients. We identified 135 pat ients with recurrent stroke. The most frequent type of recurrence was large vessel atherothrombotic stroke followed by the cardioembolic or lacunar st roke. The major contributing factors were hypertension, atrial fibrillation , and cardiomyopathies. The fatality rate did not differ from the overall m ortality by stroke in these years, but the majority of deaths occurred in l ong-term recurrences. The functional status was worse after recurrent strok e than after index stroke. Although any pattern of recurrence is possible, there is a major trend to occur in the same vascular territory by the same pathophysiologic mechanism. Recurrent stroke frequently carries a worse fun ctional status than index stroke. In many patients, despite the appropriate treatment, stroke recurrence was an unavoidable consequence.