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Previous classifications of stroke have been on
vascular territory or gross pathological subtypes. These systems provide no
information however on predisposing risk factors, predicting the recurrence
of stroke, or in guiding therapy for stroke treatment and secondary
prevention. Aetiological classifications have been used more recently which
do provide information on suitability for acute treatment, secondary
prevention measures and also the natural history of stroke. However a large
proportion of strokes remain undetermined with regard to aetiology with
these systems. Reasons for this may be due to reliance on too many
investigations and on a lack of systematic selection of investigation
required. Although we know that ethnic differences exist in the patterns of
stroke, there are limited European data on ethnic differences in subtype of
stroke.
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This will first be validated on data previously obtained
for the Stroke Register and then used prospectively on acute stroke
patients over 24 months. The results of these investigations will be used
to categorise stroke patients according to aetiology into the groups: large
artery atherosclerosis, cardioembolism, small vessel occlusion, other
determined aetiology and undetermined aetiology. This information will be
used to determine the incidence of each subtype in our population and any
ethnic differences in subtype. Patients will also be followed up at 3
months and 1 year to obtain data on mortality and functional impairment.
This will be used to determine whether there are any differences in outcome
between subtypes of stroke and between ethnic groups. A sub-study will be
performed to compare carotid plaque disease with ethnicity and also natural
history of stroke.
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