Long term survival after primary intracerebral haemorrhage: a retrospective population based study.

Objectives: To determine the long term survival and predictors of death in patients with primary intracerebral haemorrhage (ICH) in Central Finland.

Methods: Data were collected retrospectively on all adult patients with first ever ICH in Central Finland county between September 1985 and December 1991. The survival of all patients at the end of December 2002 was investigated.

Admission blood glucose and short term survival in primary intracerebral haemorrhage: a population based study.

Background: The role of admission blood glucose level on the prognosis of patients with intracerebral haemorrhage has not been elucidated.

Objective: To examine this association on the basis of an epidemiologically representative patient material.

Methods: 249 500 people living in the catchment area of the Central Hospital of Central Finland.

Blood pressure, nimodipine, and outcome of ischemic stroke.

Objectives: The reduction of blood pressure (BP) caused by nimodipine has been proposed as an explanation for the poor results in ischemic stroke trials. We evaluated further the relationships between BP, nimodipine, and outcome of ischemic stroke, and also searched for other possible explaining mechanisms.

Patients And Methods: All 350 participants of an earlier placebo controlled trial on oral nimodipine were included in this study.

Smoking and intervertebral disc degeneration.

Cigarette smokers have an increased risk of low back pain which may be caused by disc degeneration and spinal instability, for example. Ischemia, apoptosis, faulty synthesis of disc macromolecules, and an imbalance between disc matrix proteinases and their inhibitors may be involved in the pathogenesis of disc degeneration. Along with degeneration, the primary avascular disc turns vascular.

Vitamin E and beta carotene supplementation in high risk for stroke: a subgroup analysis of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study.

Context: High serum or dietary levels of vitamin E and beta carotene appear to be associated with lower risk of stroke, but studies regarding their supplementation have not supported their use in stroke prevention.

Objective: To determine if vitamin E (dl-alpha tocopherol) and beta carotene supplementations could be used in prevention of stroke in men at high risk for hemorrhagic or ischemic events.

Design: Population-based, randomized, double-blind, placebo-controlled, 2 x 2 factorial design trial (the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study), conducted from April 1985 through April 30, 1993, with median follow-up of 6 years.

Effect of nimodipine on final infarct volume after acute ischemic stroke.

Placebo-controlled clinical trials with nimodipine in acute ischemic stroke have not fulfilled the early optimistic expectations. Nimodipine has in some experimental studies, when administered either before or up to 90 min after induction of cerebral ischemia, resulted in a reduction of infarct size. No studies on the effects of nimodipine on infarct size in man have been published.

Controlled trial of alpha-tocopherol and beta-carotene supplements on stroke incidence and mortality in male smokers.

Observational data suggest that diets rich in fruits and vegetables and with high serum levels of antioxidants are associated with decreased incidence and mortality of stroke. We studied the effects of alpha-tocopherol and beta-carotene supplementation. The incidence and mortality of stroke were examined in 28 519 male cigarette smokers aged 50 to 69 years without history of stroke who participated in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC Study).

Different risk factors for different stroke subtypes: association of blood pressure, cholesterol, and antioxidants.

Background And Purpose: Blood pressure is an important risk factor for stroke, but the roles of serum total and HDL cholesterol, alpha-tocopherol, and beta-carotene are poorly established. We studied these factors in relation to stroke subtypes.

Methods: Male smokers (n=28 519) aged 50 to 69 years without a history of stroke participated in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, a controlled trial to test the effect of alpha-tocopherol and beta-carotene supplementation on cancer.

Alcohol consumption and stroke incidence in male smokers.

Background: Studies on alcohol consumption and incidences of stroke subtypes have suggested distinct dose-response relationships. Blood pressure and HDL cholesterol mediate the effect of alcohol on coronary heart disease, but similar evidence on cerebrovascular diseases is not available.

Methods And Results: We studied the risk of stroke in 26 556 male cigarette smokers 50 to 69 years of age without history of stroke.

Economic burden of stroke and the evaluation of new therapies.

Stroke is a major health problem in all industrialised countries and evidence is mounting that this problem also affects the developing countries. In the industrialised countries, it is the third largest killer and, of the survivors, about one-half are left with a permanent handicap. Despite the huge burden of stroke on healthcare and social services (several USA studies estimate the annual cost of stroke to be between US $6.

Prognostic value and determinants of first-day mean arterial pressure in spontaneous supratentorial intracerebral hemorrhage.

Background And Purpose: The onset of spontaneous intracerebral hemorrhage (ICH) is often accompanied by transient blood pressure (BP) elevation. The prognostic value and the determinants of this BP reaction have not entirely been solved, and the present study was focused on these questions.

Methods: From 1985 to 1991 in Central Finland (population, 246,000), a total of 425 patients had first-ever ICH verified by CT or necropsy.

Decreasing incidence of stroke in central Finland, 1985-1993.

Introduction: During the last decades the age-standardized stroke mortality has declined in Finland as in many other industrialized countries. Epidemiological studies have, however, not been consistent in explaining this fall in mortality. Our aim was to shed light on this question by using two consecutive, population-based surveys.

Left ventricular failure and pulmonary edema in acute multiple sclerosis.

We describe a young woman who developed left ventricular failure and pulmonary edema during fulminant onset of multiple sclerosis. One of the numerous plaques was located in the left inferior cerebellar peduncle near the dorsal motor vagal and solitary tract nuclei. Within two days pulmonary edema had cleared, and within three days left ventricular function was normal.

Factors delaying hospital admission after acute stroke.

Background And Purpose: Clinical trials of new drugs that reverse neurological deficits when used in the first hours of stroke onset suggest that early hospital admission is important. We analyzed a database of patients with acute stroke to determine the factors that delay hospital admission.

Methods: We analyzed all patients with their first stroke during 1993 in the province of Central Finland (population, 256 000).

Diurnal blood pressure variations and onset of subarachnoid haemorrhage: a population-based study.

Objectives: To analyse the association between time of onset of subarachnoid haemorrhage and diurnal blood pressure variations of ambulant normo- and hypertensive subjects.

Design: Retrospective, population-based study.

Setting: The population (246,000) of the Health Care District of Central Finland.