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Neurological Surgery No Shinkei Geka Volume 26, Issue 11 （November 1998）

Neurological Surgery 脳神経外科 26巻11号（1998年11月発行）

Japanese English

研究

脳卒中はいつ発症するか？—時間的および行動的要因について When Do Strokes Occur? : analysis of diurnal variation and activity during the onset 亀井一郎 ¹ , 大林慎始 ¹ , 中川真里 ¹ , 西林宏起 ¹ , 桑田俊和 ¹ , 兵谷源八 ¹ , 薮本充雄 ¹ , 栗山剛 ¹ , 板倉徹 ² , 駒井則彦 ² Ichiro KAMEI ¹ , Shinji OBAYASHI ¹ , Mari NAKAGAWA ¹ , Hiroki NISHIBAYASHI ¹ , Toshikazu KUWATA ¹ , Genhachi HYOTANI ¹ , Michio YABUMOTO ¹ , Tsuyoshi KURIYAMA ¹ , Toru ITAKURA ² , Norihiko KOMAI ² ¹日本赤十字社和歌山医療センター脳神経外科 ²和歌山県立医科大学脳神経外科 ¹Department of Neurosurgery, Japanese Red Cross Society Wakayama Medical Center ²Department of Neurological Surgery, Wakayama Medical College キーワード： stroke , onset , diurnal variation , hypertension , physical activity Keyword: stroke , onset , diurnal variation , hypertension , physical activity pp.991-998

発行日 1998年11月10日 Published Date 1998/11/10

DOI https://doi.org/10.11477/mf.1436901637

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Abstract 文献概要
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I．はじめに

　脳血管障害に対する診断技術および治療方法の進歩が10年も経てば隔世の感がある一方で，その疫学や予防医学がそれらと歩調を合わせて進んできたかというと必ずしもそうはいえない．社会生活上のストレスが増加し，自然環境の急激な変化がみられ，生活様式や食生活も日々変化して行く今日ならびに近未来において，疫学や予防医学に関する学問も必ず進歩して行くものと思われる．

　一般的に脳出血は活動しているときに多く発症し，脳梗塞については睡眠中ないし起床時にその発症に気づくことが多いとされているが，現在までのところこの点について詳しく検討された報告は必ずしも多くはない．

The diurnal variation and activity during the onset of stroke were examined in more than 700 consecu-tive patients. 304 cases with hypertensive intracerebral hemorrhage (HIH), 214 cases with subarachnoid hemorrhage (SAH) and 201 cases with obstructive cerebrovascular disease (OCVD) were investigated ab-out the time of onset. Concerning the activity during the onset, 296 cases with HIH, 215 cases with SAH and 198 cases with OCVD were examined. HIH occurred frequently between 1500-1800 hours, 0600-0900 hours and 1800-2100 hours. SAH occurred frequently between 0900-1200 hours, 1500-1800 hours and 1800-2100 hours. Both HIH and SAH were least likely to occur between 0000-0300 hours. OCVD exhibited a small peak incidence between 0900-1200 hours, but there were no differences between the groups for the other time periods. Both HIH and SAH were likely to occur frequently in the lavatory, while bathing and during meals. HIH also occurred frequently during physical work, while SAH occurred as frequently during mental work or housework as during hard physical labor. OCVD commonly occurred during sleep or relaxation. The relationship between diurnal variation in stroke and the circadian variation of blood pressure is discussed.

The incidence of all three types of strokes during work was higher in the non-aged group (patients under 66 years) than in the aged group (patients over 66 years). HIH and SAH occurred associated with alcohol consumption more frequently in the non-aged group than in the aged group. It is likely that the dif-ference of the time and of the activity during the onset between aged group and non-aged group reflects the difference of life-style between aged and non-aged people.