Background: There is a paucity of research on the incidence and distribution of stroke types in Greece. This is the first study investigating stroke incidence in a Greek island, the Northern Aegean island of Lesvos (Eastern Mediterranean Sea). Methods: A multisource, prospective population-based register was established and subjects with first-ever stroke (FES) between June 1st 2010 and May 31st 2011 were identified. Results: 197 FES subjects registered, 112 males and 85 females (mean age w SD = 75 w 12 years). Cerebral infarction was diagnosed in 77.7%, intracerebral hemorrhage in 12.7%, subarachnoid hemorrhage in 2.5%; undetermined stroke accounted for 7.1%. The crude annual incidence rates of FES were 227.9 (95% CI 196-260) per 100,000. Following age- and gender-standardization to the ‘European' population, FES incidence rates were 117 (95% CI 99-136). Early case fatality was 20.81% (95% CI 16-27%). Conclusions: The present findings indicate that the incidence of FES in the studied Mediterranean population is at the low end of the range of estimates established by recent European registers. The results of the present study extend the limited epidemiological data on stroke in Greece and can help guide future monitoring, prevention and treatment strategies. i 2014 S. Karger AG, Basel

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