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for the Lausanne Stroke Registry Group
Department of Neurology (Drs. Bogousslavsky, Cachin, Regli, and Despland) and Division of Cardiology (Dr. Kappenberger), Centre Hospitalier Universitaire Vaudois, and University Institute of Social and Preventive Medicine (Dr. Van Melle), Lausanne, Switzerland.
We studied clinical characteristics and coexisting causes of stroke in 305 patients admitted to a population-based primary care center with an initial ischemic stroke and a potential cardiac source of embolism (PCSE). Using systematic standardized cardiac, arterial, and cerebral investigations and the logistics of the prospective Lausanne Stroke Registry, we found that nonprogressive onset, hemianopia without hemiparesis or hemisensory disturbances, Wernicke's aphasia, ideomotor apraxia, involvement of specific territories (posterior division of middle cerebral artery, anterior cerebral artery, cerebellum, multiple territories), and a hemorrhagic component were associated with the presence of a PCSE, as compared with 1,006 initial ischemic stroke patients without PCSE. Although age and sex did not differ, the frequency of hypertension, diabetes, cigarette smoking, elevated blood cholesterol, and deep hemispheric or brainstem infarcts was higher in the patients without a PCSE. Nearly one-fourth of the patients with a PCSE had a coexisting potential arterial cause of stroke (large artery 
50% stenosis or small-vessel disease). In the majority of patients with a PCSE (76.7%), cardioembolism was the most likely cause of stroke, although a direct source of embolism was uncommon (4.3%) and intracranial embolie occlusions were present in less than one-half of the patients who were angiographed.
Address correspondence and reprint requests to Dr. J. Bogousslavsky, Service de Neurologie, CHUV, 1011 Lausanne, Switzerland.
Received August 8, 1990. Accepted for publication in final form November 20, 1990.
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