$426 Thursday, November 10, 2005 Poster Abstracts

performed within 6 hours after symptom onset. Stenosis (i_>50%) or occlusion of ipsilateral ACA was investigated and correlated with attgiographic grade of LCF: 0 - no collaterals to the ischemic site even at venous phase; 1 - collaterals to the periphery of the ischemic site with persistence of some of the defect; 2 -- collaterals with complete attgiographic blood flow of the ischemfic bed by the late venous phase. Results: Eleven (38?/;) patients showed stenosis or occlusion of ACA. Occlusive AC.As were observed in 6 out of 7 patients with grade 0 LCF compared to 1 out of 14 patients with grade 2 LCF (P -- .001). Patients with occlusive ACAs had significantly lffgher baseline median NIHSS score than those without (117 vs 10.5, P < .01). Follow-up median NIHSS scores were also higher in patients with occlusive AC.As at 1 day (118 vs 8, P < .01), and at 7 day (113.5 vs 4, P - .01) after thrombolyfic therapy. Independency rate was lower in patients with occlusive ACAs (118°,5 vs 61 °,5, P - .052). Conclusions: Combined stenosis or occlusion of ACA was not uncommon in acute MCA stroke and may suggest poor collateral flow, severe clinical manifestation, and less favorable outcome after thrombolytic therapy.

1279 Stroke incidence and relapsing patterns in rmal geriatric Japanese area

Okada, K l, Umegae, N ~, Yamaguchi, T ~, Hongo, E l, and Kobayashi, S. ZDepartment of Neurology, Oda ~unicipal Hospital'Oda, Shimane, Japan; 2 Departemnt of Neurology, Hematol- ogy & Rheumatology, Faculty of Medicine, Shimane University, Izumo, A~imane, Japan

Background: The incidence of stroke and relapse is an important medical and socioeconomic problem in Japan. Our hospital is located in an area of Japan in which 34.6°,5 of the 70,000 inhabitants are over 65 years old. To reveal the specific features of stroke in tiffs geriatric society, we compared stroke subtype and relapse patterns for our hospital with data from the Japan Standard Stroke Registry Study OSSRS). Methods: The JSSRS databank is a computer-based multi-center stroke database covering 115 hospitals nationwide. Our hospital joined this data bank since 2000. We collected 485 ischemfic stroke cases between 2001 and 2004. We analyzed the registered data, focusing on stroke subtype and relapse patterns in the acute and chronic periods. Results: The mean age of our ischemic stroke subjects was 76.4 years compared with 70.9 years for the JSSRS. In our hospital, the stroke subtypes were atherothrombotic infarction (AI: 36%), lacunar infarction (iLl: 42%), and cardiogenic embolism (ICE: 21%). The respective rates for the JSSRS were AI 33?/;, LI 32?/;, and CE 27?/;. Seventy-four subjects (115.2%) suffered a relapse: 69 subjects had an ischemic stroke and 5 subjects had cerebral bleeding. The subtypes of relapse in acute stage were AI 47%, CE 29°,5, and LI 21°,5. By contrast, relapses in chronic stage were A133%, CE 28°,5, LI 25 °,5, and cerebral bleeding 14%. Conclusion: The specific features in a geriatric population in Japan revealed the importance of considering stroke subtypes for secondary prevention.

1280 Timing of Acute Stroke presentation and patient attitude towards Intravenous Thtombolysis in a Singapore Stroke mill

Ong, S 1, Elmnba, D 1 , De Silva, D 2 , Chang, H 2, Chen, C 2, Wong, M 2. ~Singapore General Hospital' Singapore; 2National Neuroscience Institute, Singapore

Background: Thrombolysis in acute cerebral infarction is proven to be efficacious but has a high risk ofintracranial bleeding. Singapore has just received its license for its usage in acute cerebral infarction. We aimed to study hospital presentation times of our patients, reasons for delay and their response to thrombolysis if offered.

Methods: This was a prospective study of 100 consecutive patients admitted from June 2004. All patients were interviewed with a standardized form. Data collected included stroke subtypes, choice of 9 options of reasons for delay and acceptance of thrombolysis if hypothetically offered. Results: There were 53% males, with a mean age of 66.73°,5 were Chinese, 127/; Malays, 14% Indians and 1% Eurasian. Median time of arrival to hospital from stroke onset was 965 minutes. 9% arrived within 2 hours, and another 3?/; within 3 hours. Factors significantly associated with presentation within 3 hours were large strokes (p -- 0.001), Indian race (p -- 0.04) and no pre-hospital consultation (lJ - 0.003). Main reasons for delay were lack of awareness of stroke symptoms and severity of condition (50?/;) andinability to seek medical attention unaided (12%). 34% would accept thrombolysis if offered. Conclusion: The majority of our patients arrived after the window period for thrombolysis. We have identified lack of awareness of stroke symptoms as the major obstacle to providing an effective throm- bolysis service in our hospital. Our resources should be focused at public education on recognition of stroke symptoms and the potential benefits of early presentation to hospital if eligible for thrombolysis.

1281 Acute Slroke mortality in South West Nigeria

Osalusi, B l, Ogun, S 1, Ojini, F ~, Danesi, M 2, Kolapo, K 1. lOgun state University Teaching Hospital' Sagamu, Nigeria; Z Lagos University Teaching Hospital' Lagos, Nigeria

Background: Stroke is a significant economic, social and medical problem worldwide. This retrospective follow-up study aimed to review the pattern and time trend mortality of stroke. Method: Record of all stroke patients adnfftted into Ogun State University Teaching Hospital, Sagamu, from December 1993 to November 2003 were reviewed. Patients were classified into haemor- rhage or infarct using the WHO criteria. Information was obtained as to the time of death in those who died and mortality at 24 hours, 7 days, 30 days and 6 months recorded. Autopsy records were also reviewed. Data analyses were done by standard statistical methods and the use of Epi-info 2002. Results: A total of 708 stroke patients were reviewed and tiffs constituted 2.4% of all adult emergency admissions. On clinical ground, 48.6% of the patients had infarctive stroke, 45.2?/; had intracerebral haemorrhage while 6.2% had subarachnoid haemor- rhage. Stroke constituted 1.8°,5 of death at the emergency unit and the case-fatality rate was 9% at 24 hours, 28% at 7 days, 40% at 30 days and 59% at 6 months. Hypertension, old age, obesity, 'cryptogenic/ unknown cause" and brain stem stroke were preditors of high mortality. Conclusion: A changing pattern of the stroke subtype with an increasing frequency of haemorrhagic stroke in our population is suspected. Stroke constitute a significant cause of mortality at all post- ictal period and the need for prompt institution of intensive care treatment within the first 24 hours and beyond, as well as other supportive measures was emphasised.

1282 Sulcal Hyperintensity on Fluid-Attenuated Inversion Recovery Imaging as a marker for Hemorrhagic Transformation in Acute Isehemic Stroke

Vedolin, L 1, Ouriques-Martins, SC z, Folgierini, M 1, Krutter, D ~, FrietMctl, M 2, Brondani R 2, Manenti E 2, Rech, R 2, Jaeger, C 2, Silveira, D 2, Komlts , M 3, Ehlers JA 2. 1Neuroradiologist, Vascular Unit of the M~e de Deus Hospita[, Porto Alegre, Brazil," 2Stroke Team, Vascular Unit of the Mde de Deus Hospital' Porto Alegre, Brazil," 3Radiologist trainee, Mde de Deus Hospital' Porto Alegre, Brazil

Background: Disruption of the blood-brain barrier resulting from reperfusion is a potential cause of hemorrhagic transformation (HT) and worse clinical outcome in hyperacute stroke. Our purpose was to