Left-Sided Strokes Are More Often Recognized Than Right-Sided Strokes: The Rotterdam Study. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Portegies, Marileen L.P.; Selwaness, Mariana; Hofman, Albert; Koudstaal, Peter J.; Vernooij, Meike W.; Ikram, M. Arfan
• Is Part Of: Stroke. Volume 46:Issue 1(2015)
• Publication Date: 2015-01
• Subjects: epidemiology -- magnetic resonance imaging -- stroke; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.114.007385
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: Left-sided strokes are reported to be more common than right-sided strokes, but it is unknown whether they occur more often or are simply recognized more easily by clinicians. In a large unselected community-dwelling population, we examined the frequency of clinical left- and right-sided strokes and transient ischemic attacks (TIAs) and compared it with the frequency of left- and right-sided infarcts on MRI. Methods—: This study was conducted within the population-based Rotterdam Study. Between 1990 and 2012, 13 894 participants were followed up for first-ever stroke and TIA. MRI scans were performed within a random subgroup of 5081 persons and were rated for the presence of supratentorial cortical and lacunar infarcts. We compared frequencies of left- and right-sided strokes, TIAs, or MRI infarcts using binomial and Fisher exact tests. Results—: After a mean follow-up of 9.6 (±6.0) years, 1252 patients had a stroke, of which 704 were ischemic, and 799 participants had a TIA. Within the subgroup with MRI, we identified 673 infarcts. Ischemic strokes were more frequently left-sided (57.7%; 95% confidence interval, 53.7–61.6) than right-sided, similar to TIAs (57.8% left-sided; 53.4–62.3). In contrast, we found no left-right difference in distribution of infarcts on MRI (51.9% left-sided; 48.1–55.6). Conclusions—: Clinical ischemic strokes and TIAs are more frequently left-sided than right-sided, whereas this difference is not present for infarcts on MRI. This suggests that left-sided strokes and TIAs are more easily recognized. Consequently, there should be more attention for symptoms of right-sided strokes and TIAs. Abstract : Supplemental Digital Content is available in the text.