engleski

Haemorrhagic stroke in eastern Croatia in the years 1987-1995

The authors have analyzed the epidemiological and clinical peculiarities of hemorrhagic stroke in the city of Osijek, a big industrial, trade and cultural center of the eastern Croatia, in the last nine years since the computerized tomography (CT) has been used in the diagnostics, and specifically the possible influences of the Croatian Defense War ( 1991--1995) on the appearance of hemorrhagic stroke. Being under constant pressure and cruel attacks on civilian population from the surrounding occupied territories, the city experienced the worst destructions during the 1991-1992 period. A retrospective analysis disclosed a nearly continuous increase of hemorrhagic strokes (spontaneous cerebral and subarachnoid hemorrhage-SAH) in the observed period, from 9..3 (in 1987) to 27.6% (in 1993), with the mean percentage of 15.5% from all the treated stroke patients. The most impressive variations in the participation of hemorrhagic strokes in the total number of strokes were between the period of intensive war actions (24.79%) and the compa-rable peace period ( 14.04%). In spite of continu-ous fluctuations in number and type of stroke cases, our analyses give support to the hypothesis that the observed variations are not a mere coincidence, but are resulting from continuous stress due to the war. These observations pertain also to the registered patients of SAH, with a clear cut sudden decline of SAH cases in the last year, what could be explained as a upool-depletion" phenomenon. Some observations of this kind were described during the Persian Gulf War in two hospitals in Jerusalem (Kleinman et al, Neuro-logy 1992,42: 2225-2226). On the other hand there are indices on the more favorable final outcome of patients with hemorrhagic strokes, probably due to the application of recent diagnostic and manage-ment possibilities, including surgical treatment.

Stroke; neuroepidemiology; haemorrhagic

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