J Korean Neurol Assoc.  1998 Oct;16(5):609-615.

Precipitants of Stroke: Roles of Risk Factor Changes, Preceding Infection, Exposure to Coldness, and Psychologic Stress

• Chung SJ
• Kim JS
• Lee CH

Abstract

BACKGROUND: Whether the changes of risk factors (hypertension, diabetes mellitus, smoking, alcohol) can precipitate stroke remains unknown, and antecedent infection and psychologic stress are described insufficiently as predisposing risk factors for cerebral infarction. Therefore, we attempted to examine the roles of recent infection, psychologic stress, and the changes of risk factors as potential precipitants in each stroke subtypes. We also tested the temporal relationship between preceding exposure to coldness and stroke onset.
METHODS
In this case-control study, 113 consecutive patients with acute cerebrovascular disease (38 small vessel disease, 43 large vessel disease, 11 cardiogenic infarction, 4 infarction of undetermined cause, and 17 intracerebral hemorrhage) and 23 control subjects were evaluated. Changes of the risk factors (and their management) were interviewed. A sign/symptom based questionnaire was used to characterize the prevalence of recent prior infection and exposure to coldness. Psychologic stress was measured with the use of Social Readjustment Rating Scale.
RESULTS
The negative change of alcohol drinking was significantly higher in the stroke group. However, there was no significant difference between stroke and control groups in the changes of the other risk factors. The prevalence of previous (within 1 month) infection was significantly higher in the stroke group compared with control subjects (p=0.03). However, there were no significant differences among the stroke subtypes in the prevalence of infection(p=0.08). Upper respiratory tract infections constituted the most common type of infection. The exposure to coldness was significantly higher in the stroke group compared with control subjects (p=0.002). The level of stress within the prior 1 month/1 year was significantly higher in the stroke group than control group (p=0.01).
CONCLUSION
Our data suggest that preceding infection, exposure to coldness, psychologic stress, and the negative change of alcohol drinking may be com.

Keyword

Stroke; Precipitants; Infection; Coldness; Stress

MeSH Terms

Alcohol Drinking
Case-Control Studies
Cerebral Infarction
Diabetes Mellitus
Humans
Infarction
Prevalence
Surveys and Questionnaires
Respiratory Tract Infections
Risk Factors*
Smoke
Smoking
Stress, Psychological*
Stroke*
Smoke