NATURAL HISTORY OF CEREBRAL THROMBOSIS 9 TO 19 YEAR FOLOW-UP

The natural history of cerebral thrombosis was studied in an unselected series of 843 cases followed for a period of 9-19 yr. Life tables were designed for sex, age, hypertension and functional status. A sex-age relationship was observed. Below 60 yr the incidence was higher in men than in women. The reverse was true after 70 yr of age. Male/female ratio decreased steadily as age advanced. Either sex was affected with almost equal severity by the disease. The initial mortality was 23 per cent. It increased linearly with advancing age and the extent of the neurological deficit at the time of the first attack. Depressed sensorium proved to be a bad prognostic sign, but its presence, even in the form of coma, did not necessarily result in death or severe residual disability. Of the 648 survivors, 260 (40 per cent) lived 5 yr, 118 (18 per cent) were alive at 10 yr and only 26 (4 per cent) survived 14 yr. The slope of the life expectancy curve of the patients who survived beyond six years paralleled that of the general population. Among 522 survivors, deaths were caused by recurrent strokes in 212 (41 per cent) and by heart disease in 159 (30 per cent). In long-term survivors mortality rates increased linearly with advancing age. However, relative life expectancy was not influenced significantly by age. Neither hypertension nor sex had an adverse effect on the prognosis. Association of ischemie heart disease did not increase the chance of dying of a stroke. The extent of initial neurological deficit was more important than the speed and completeness of recovery as a prognostic factor. The course of the disease was relatively benign if the initial neurological involvement was only minor and followed by complete recovery. If residual disability existed, its degree did not influence the late prognosis appreciably. © 1968.