Etiological characterization of ischemic stroke in a neurovascular care unit in Mexico

Objective: This study aimed to elucidate the diagnostic experience of our neurovascular care unit (NCU) in managing consecutive cases of cerebral infarction, detailing the prevalence of etiologies using the Trial of Org 10172 in acute stroke registry (TOAST) classification and comparing it with prior Mexican studies.Methods: A descriptive study of consecutive cases was conducted on patients diagnosed with ischemic stroke hospitalized in our NCU from September 2019 to July 2022.Patients underwent standardized diagnostic assessments by internists and neurologists, including neuroimaging (computed tomography [CT] and/or magnetic resonance imaging of the brain) and complementary studies (carotid Doppler ultrasound, 24-h Holter monitoring, echocardiogram).All patients had TOAST etiological classification, National Institute of Health Stroke Scale, and modified Rankin Scale evaluations.Results: A total of 738 subjects (57% male and mean age of 61 years) were included.Hypertension (61%), diabetes (49%), and dyslipidemia (11%) were common risk factors.Neuroimaging was performed on 95.7% of patients, with CT being the most prevalent (72.8%).The TOAST classification revealed 31.3%atherothrombotic, 24.7% lacunar, 15.4% cardioembolic, and 25.5% cryptogenic cases.Conclusions: The establishment of NCUs enhances ischemic stroke management, improving patient outcomes and reducing recurrence.Until stroke units become widespread, a structured evaluation by trained specialist physicians remains essential.