Epidemiology of Cerebrovascular Disease
This work started out quite modestly as an investigation into the geographic distribution of cerebrovascular disease. But one question soon led to another and it just growed, like Topsy. In fact, it is hard to characterize precisely what this should be ca
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Epidemiology of Cerebrovascular Disease With 42 Figures
Springer-Verlag Berlin· Heidelberg. New York 1969
John F. KURTZKE, M. D. Professor of Neurology and Professor of Community Medicine and International Health, Georgetown University School of Medicine; Chief, Neurology Service, Veterans Administration Hospital, Washington, D.C.; Consultant in Neurology, U.S. Naval Hospital, National Naval Medical Center, Bethesda, Md.
ISBN 978-3-642-86615-9 DOl 10.1 007/978-3-642-86613-5
ISBN 978-3-642-86613-5 (eBook)
All rights reserved. No part of this book may be translated or reproduced in any form without written permission from the Publishers. © by Springer-Verlag Berlin - Heidelberg 1969. Library of Congress Catalog Card Number 77-76725. Title No. 1568 Softcover reprint of the hardcover I st edition 1969
To my wife
Foreword This work started out quite modestly as an investigation into the geographic distribution of cerebrovascular disease. But one question soon led to another and it just growed, like Topsy. In fact, it is hard to characterize precisely what this should be called. It is in part a Review of the Literature, in part a critique and reworking of other publications, and in part a standard view of stroke epidemiology in the more restricted sense of attack and mortality rates and distribution. Still the result would I hope provide a synthesis of the population features of stroke as they appear to me at this time - a highly individual interpretation of the "state of the art". I have studiously avoided any survey of the history of cerebrovascular disease, and citations are for those of most recent vintage appropriate to the situation. Literature in this field continues to burgeon; my references end with the Fall of 1967. When counting noses we must have numbers, so the reader will find a massive compilation of tables. They are however necessary, especially since so many of my statements seem to fly in the face of current orthodoxy, whether lay or medical. With the data, one may decide for himself their validity. Insofar as possible tables have been placed in the appendix. Unless an author is directly quoted by me, all interpretations of his data are my own and he should be held blameless. Additionally, nothing in this work should be construed as representing the opinions or policy of the Veterans Administration, the Department of the Navy, or Georgetown University. November 1, 1968
J. F. KURTZKE
Contents List of Text Tables. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
IX
List of Figures ...................................................
XI
List of Appendix Tables ........................................... XIII Chapter I. Epidemiology. Definitions and Methods .................... Epidemiologic Methods. Case-Material Sources. Statistical Testing. References.
1
Chapter II. Definitions of Cerebrovascular Disease. . . . . . . . . . . . . . . . . . . . . International Statistical Classification of CVD. Clinical Definitions. References.
8
Chapter III.
