Increased Large Vessel Occlusive Strokes After the Christchurch March 15, 2019, Terror Attack

Abstract

Sudden catastrophic events such as terror attacks have clear and immediate consequences for the people who are directly affected. However, less is known about the impact on the physical health of local community members (online supplemental available from Dryad doi.org/10.5061/dryad.bcc2fqz9t for further discussion). Acute psychological stress may cause a parallel physiologic response increasing risk of cardiovascular events.1-3 On March 15, 2019, a gunman shot and killed 51 people praying at the Al Noor and Linwood mosques in Christchurch city, New Zealand. We observed an increase in ischemic stroke reperfusion treatments in the week starting Monday, March 18, 3 days after the terror attack. We hypothesized that this observation could have occurred because of either an effect of the attack on the total number of ischemic strokes and/or the severity of these strokes, or coincidence. We investigated these possibilities by analyzing the association between the terror attack and rate of stroke reperfusion treatment, proven intracranial large vessel occlusion (LVO), and total stroke admissions at Christchurch hospital and the national stroke data set.