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Vol. 15, No. 1-2, 2003
Issue release date: January 2003
Cerebrovasc Dis 2003;15:70–77

Two-Peak Temporal Distribution of Stroke Onset in Greek Patients

A Hospital-Based Study

Spengos K. · Vemmos K.N. · Tsivgoulis G. · Synetos A. · Zakopoulos N.A. · Zis V.P. · Vassilopoulos D.
Departments of aNeurology, University of Athens School of Medicine, ‘Eginition’ Hospital and bClinical Therapeutics, University of Athens School of Medicine, ‘Alexandra’ Hospital, Athens, Greece

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A circadian distribution with a single peak of stroke onset in the morning hours has been described in various countries. Analysis of the temporal pattern of symptom onset in a series of 1,253 Greek first-ever stroke patients revealed a circadian distribution with two incidence peaks between 08.00 and 10.00 h, and between 16.00 and 18.00 h. Considering the different etiopathogenic types of stroke, the same two-peak time pattern was evaluated in all stroke subgroups with the only exception of lacunar stroke, which seems to predominantly occur during night and sleep. A secondary stroke onset peak in the late afternoon has not been previously described in such detail. A relation between the second, however lower, frequency peak and the traditional Greek habit of afternoon sleep (siesta) could be assumed and deserves further investigation.

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