An analysis of ischemic stroke in an urban southern California population. The University of California, San Diego, Stroke Data Bank.

Background: Stroke databanks may provide important information regarding regional and temporal variations in the causes of stroke. Methods: Five hundred consecutive patients presenting to the University of California, San Diego, stroke services with acute ischemic stroke were evaluated prospectively. A specific cause of stroke was assigned in each case according to predetermined diagnostic criteria. Results: Relative incidences of ischemic stroke causes were as follows: lacunar, 27%; unknown cause, 23%; cardioembolic, 22%; large-vessel atherothrombotic/embolic, 18%; and miscellaneous, 10%. Conclusions: These relatively high rates of lacunar stroke and stroke of unknown cause are similar to those from other recent surveys and may reflect an important shift in the pathophysiologic mechanisms that underlie ischemic stroke. (Arch Intern Med. 1993;153:619-624)