Cerebrovascular diseases in Africans

Abstract

It is the belief of many doctors working in Africa that circulatory disorders in the atherosclerotic sense are not as common as in Europe. I have that same opinion for several reasons. In the first place we rarely see arteriosclerosis at post mortem examination and when we do so at our neuropathology sessions everyone crowds around to see the specimen. It is our impression however that when a vessel is affected by arteriosclerosis, and it is the basilar artery whose branches seem primarily involved, the involvement is of a very severe kind.Secondly I have never once explored the carotid bifurcation of an African patient for stroke and yet it is not an uncommon operation in Europe. This is not because our physicians are unaware of the condition of localized atherosclerosis, the majority of younger patients suffering an apparent cerebral thrombosis are subjected to arteriography, but none to date have required a cleaning out of the carotid bifurcation or of other accessible portions of the carotico-vertebral system. Finally, ruptured cerebral aneurysm and sub-arachnoid haemorrhage are less commonly seen than the size of the population would lead one to expect. It is of course therefore only an impression but I believe that age for age the arteriosclerotic rate is lower in Africans than it is in Europeans.