Time of the day and season distribution among stroke code subtypes: differences between ischemic stroke, intracranial hemorrhage, and stroke mimic.

Background: Circadian variations in the timing of the onset of stroke symptoms have been described, showing a morning excess of cardiovascular risk. To date, no differences have been found between stroke subtype and time distribution throughout the day. The present study aims to compare the seasonal and circadian rhythm of symptoms onset in ischemic, hemorrhagic, and stroke mimic patients. Methods: This study was conducted prospectively at a hospital and involved a cohort of stroke alert patients from 2018 to 2021. Stroke subtypes were classified as ischemic stroke, intracerebral hemorrhage (ICH), transient ischemic attack (TIA), and stroke mimic. Clinical variables were recorded, and each patient was assigned to a 4-h interval of the day according to the time of onset of symptoms; unwitnessed stroke patients were analyzed separately. Seasonal changes in stroke distribution were analyzed at 3-month intervals. Results: A total of 2,348 patients were included in this analysis (ischemic 67%, ICH 13%, mimic 16%, and TIA 3%). Regardless of stroke subtype, most of the patients were distributed between 08-12 h and 12-16 h. Significant differences were found in the time distribution depending on stroke subtype, with ICH predominating in the 4-8 h period (dawn), most of which were hypertensive, TIA in the 12-16 h period (afternoon), and stroke mimic in the 20 h period (evening). The ischemic stroke was evenly distributed throughout the different periods of the day. There were no differences in the seasonal pattern between different stroke subtypes, with winter being the one that accumulated the most cases. Conclusion: The present study showed different circadian patterns of stroke subtypes, with a predominance of ICH at dawn and stroke mimic in the afternoon. The stroke circadian rhythm resembles previous studies, with a higher incidence in the morning and a second peak in the afternoon.

[Ingestion of anabolic steroids and ischaemic stroke. A clinical case report and review of the literature]. / Ingesta de esteroides anabolizantes e ictus isquemico. Presentacion de un caso clinico y revision de la bibliografia.

INTRODUCTION. Anabolic-androgenic steroids are synthetic substances derived from testosterone that are employed for their trophic effect on muscle tissue, among other uses. Their consumption can give trigger a series of adverse side effects on the body, including the suppression of the hypothalamus-pituitary-gonadal axis as well as liver, psychiatric and cardiovascular disorders. The most common effects are altered fat profiles and blood pressure values, cardiac remodelling, arrhythmias or myocardial infarcts. CASE REPORT. We report the case of a young male, with a background of anabolic-androgenic steroids abuse, who visited because of an acute neurological focus in the right hemisphere related with an ischaemic stroke. The aetiological study, including cardiac monitoring, echocardiograph and imaging studies (magnetic resonance and arteriography) and lab findings (thrombophilia, serology, autoimmunity, tumour markers) showed no alterations. CONCLUSIONS. The association between consumption of anabolic-androgenic steroids and cardiovascular pathologies is known, but its relation with cerebrovascular disease has not received so much attention from researchers.

Ingesta de esteroides anabolizantes e ictus isquémico. Presentación de un caso clínico y revisión de la bibliografía / Ingestion of anabolic steroids and ischaemic stroke. A clinical case report and review of the literature

Introducción. Los esteroides androgénicos anabólicos son sustancias sintéticas derivadas de la testosterona, utilizados, entre otros usos, por su efecto trófico sobre el tejido muscular. Su consumo puede producir una serie de efectos adversos sobre el organismo, entre los que destacan la supresión del eje hipotálamo-pituitario-gonadal, alteraciones hepáticas, psiquiátricas y cardiovasculares, y los efectos más frecuentes al respecto son la alteración del perfil lipídico y de las cifras tensionales, la remodelación cardíaca, la producción de arritmias o el infarto de miocardio. Caso clínico. Varón joven, con antecedentes de abuso de esteroides androgénicos anabólicos, que consulta por focalidad neurológica hemisférica derecha aguda en relación con un ictus isquémico. El estudio etiológico, incluyendo monitorización cardíaca, estudio ecocardiográfico, de imagen (resonancia magnética y arteriografía) y analítico (trombofilia, serologías, autoinmunidad, marcadores tumorales), no mostró alteraciones. Conclusiones. La asociación entre consumo de esteroides androgénicos anabólicos y patología cardiovascular es conocida,pero no se ha estudiado tanto su relación con la patología cerebrovascular (AU)

Introduction. Anabolic-androgenic steroids are synthetic substances derived from testosterone that are employed for their trophic effect on muscle tissue, among other uses. Their consumption can give trigger a series of adverse side effects on the body, including the suppression of the hypothalamus-pituitary-gonadal axis as well as liver, psychiatric and cardiovascular disorders. The most common effects are altered fat profiles and blood pressure values, cardiac remodelling, arrhythmias or myocardial infarcts. Case report. We report the case of a young male, with a background of anabolic-androgenic steroids abuse, who visited because of an acute neurological focus in the right hemisphere related with an ischaemic stroke. The aetiological study, including cardiac monitoring, echocardiograph and imaging studies (magnetic resonance and arteriography) and lab findings (thrombophilia, serology, autoimmunity, tumour markers) showed no alterations. Conclusions. The association between consumption of anabolic-androgenic steroids and cardiovascular pathologies is known, but its relation with cerebrovascular disease has not received so much attention from researchers (AU)