Treatment of cerebral ischemia now stands on the frontier of a new era where emphasis will be placed on clinical outcomes. It is important to use the best clinical and technological information available to develop outcome based predictors for patients with ischemic stroke. It is also important to continue to explore how improvements in technology may enhance our ability to predict and influence clinical outcomes. The projects are designed to predict stroke outcome: 1) Data from a population-based study of ischemic stroke patients less than 45 years of age will be analyzed. The contribution of cerebral angiography in determining stroke etiology and complication rate of cerebral angiography will be described; 2) The recurrence of ischemic stroke and other thromboembolic events will be determined in a group of ischemic stroke patients with normal or abnormal echocardiograms. The rate of recurrence of embolic events in patients with and without atrial septal aneurysm, aortic arch atheroma, intracardiac thrombus and other abnormalities will be compared; 3) The NINDS Stroke Data Bank will be analyzed to develop a multivariable predictor of 30 day and l year survival and stroke recurrence for patients with cerebral infarction. These predictors will be validated using data to be collected from the ongoing Maryland Stroke Data Bank (MSDB); and 4) Long term followup data which is available for patients enrolled at the University of Maryland Medical Center in the Pilot, NINDS and MSDB from 1980 to l989 will be analyzed. This database of over a 1000 patients will be used to test and refine a previously published predictor on the risk of stroke recurrence at 2 years. New predictors of death and stroke recurrence at 2, 5 and 10 years will be developed. These projects will improve the ability to predict stroke outcomes and will explore the contribution of new technologies to stroke diagnosis and outcome.
