Stroke Admission to Tikur Anbassa Teaching Hospital: With Emphasis on Stroke in the Young

Abstract

Background: Although the burden of cerebrovascular accident is not known in Africa, including Ethiopia, it is a frequent cause of mortality and morbidity in hospital practice. Stroke in the young is associated with a different spectrum of risk factors and treatment outcomes as compared to stroke in the older age group. Method: To assess potential risk factors associated with stroke; and to compare the types and frequencies of these potential risk factors for stroke in the young and stroke in the older age groups, a retrospective case study of all stroke patients admitted to Tikur Anbassa Teaching Hospital in Ethiopia, over a 6-year period (September 1990 to August 1996), was undertaken. Results: 259 patients, age 15-44, who satisfied the definition of stroke were admitted to Tikur Anbassa Teaching Hospital. Stroke in the young accounted for 28% (73 patients). Hypertension was the most common risk factor in both age groups. Rheumatic heart diseases (RHD) was the second most common risk factor after hypertension, present in 29% of young stroke patients while it was absent in the older age. All the rheumatic heart disease (RHD) cases had mitral valve involvement (mainly mitral stenosis), nearly all having milder forms of the disease. Only 9 of 21 patients with RHD had established atrial fibrillation. Conclusion: Rheumatic heart disease is an important risk factor among young stroke patients and the type of valve involved rather than severity of disease is related to the occurrence of stroke. If confirmed on subsequent prospective studies, this finding will have an impact on indication for anticoagulation in RHD.