Background: Stroke is one of the major death causes in Uruguay andin the world.Objective: For this motive, we have designed this study to describe andto analyze stroke mortality tendency in Uruguay between 1950 and2008. Its relationship with gender, imaging techniques, intensivetreatments, gross domestic product (GDP), and mortality in othercountries was analyzed.Methods: An ecologic study of mortality trends, standardized genderand age rates, and Poisson regression models and autocorrelation wasperformed.Results: Themortality trend has decreased throughout the studied time,with two periods, an increasing one until 1971, and then a decreasingperiod until 2008. The female gender presented higher mortality. Thedecreasing period coincides with the introduction of intensive care units(ICU) and the computerized tomography (CAT) scan. The GDP showed anegative correlation with the decrease of stoke mortality.Conclusions: Uruguay has had a decline in stroke mortality placingitself in an intermediate position in comparison to other countries.CAT scan techniques, ICU centers and an increase in the GDP seem tohave had a positive effect in the decline of stroke mortality.

doi:10.1016/j.jns.2013.07.834

Abstract — WCN 2013No: 1651Topic: 3 — StrokeMultidisciplinary stroke early supported discharge program in alocal hospital: Outcome and safety

W.C. Fonga, S.T. Chana, C. Chaob, T. Fungc, V. Kwoka, A. Tsoia, P. Laub,K.F. Leungc, J.H.M. Chana, P.C.K. Lia. aDepartment of Medicine, QueenElizabeth Hospital, Hong Kong, Hong Kong Special AdministrativeRegion; bDepartment of Physiotherapy, Queen Elizabeth Hospital, HongKong, Hong Kong Special Administrative Region; cDepartment ofOccupational Therapy, Queen Elizabeth Hospital, Hong Kong, HongKong Special Administrative Region

Background: Recent meta-analysis had demonstrated that earlysupported discharge is equally effective as compared with prolongedinpatient rehabilitation. Stroke Early Supported Discharge (SESD)Program was then implemented since Dec. 2011. Timely home basedrehabilitation and careers' training would be provided to thosepatients eligible for early discharge.Objective: This study aims to show whether our SESD program can beeffective and safe outside clinical trial setting.Method: This study reviewed the outcome and safety parameters afterthe introduction of the program. Data were prospectively collected andcompared before and after the introduction of the program.Results: From Dec. 2011 till Sept. 2012, 283 patients were recruitedinto the SESD program. Their mean age was 70. Half of the patientshad Modified Barthel Index (MBI) less than 85. After the programwas implemented, the proportion of acute stroke patients directlydischarged without transfer to rehabilitation unit, was significantlyincreased from 43.5% to 49.2% (p = 0.005). The average length ofstay of those patients was 5.08 days. For the functional recovery, theMBI and Berg Balance Scale (BSS) were significantly improved afterhome based rehabilitation as compared with their baseline upondischarge (mean MBI from 81.2 to 91.9, p b 0.001, mean BSS from40.4 to 46, p b 0.001). Their unplanned readmission rate, within4 weeks from discharge, was 10.2%, which was lower than that of allthe stroke patients (12.3%) in the same period (p = 0.055).Conclusions: The SESD program was effective and safe to facilitatedirect discharge of acute stroke patients from acute hospital.

doi:10.1016/j.jns.2013.07.835

Abstract — WCN 2013No: 1636Topic: 3 — StrokePredictive value of imbalance grade and F-score to identify strokein dizziness patients

J. Seo, H. Jung, E. Kim. Neurology, Inje University, Paik Hospital, Busan,Republic of Korea

Background: In patients presenting dizziness, there is no definitecriterion to distinguish between the central and peripheral etiologybased on their symptom quality. Although dizziness is usuallyconsidered to be benign etiologies, not infrequently acute dizzinesscases could herald a cerebrovascular disease. But lack of objective riskstratification schemes of cerebrovascular disease makes cliniciansperplexed. At this point, we aimed to assess the effectiveness aboutthe cerebrovascular disease risk stratification systems such as hardcoronary heart disease 10 year risk score in Framinghamheart study (F-score) and specialized examinations such as imbalance grade.Methods:Weperformed retrospective study presenting symptomwithwhirling/non-whirling type dizziness, vertigo or disequilibrium. Pe-ripheral type vertigo was excluded. MRI was taken in all includedpatients to define ischemic lesions. ABCD2, CHADS2, F-Score, andimbalance grade (0 to III) were calculated using clinical informationfrom the medical records. Statistical analysis was done with chi squareand logistic regression.Results: Among the 145 patients (mean age, 59.8 ± 10.3), ischemicstrokewas diagnosed in 27 (18.6%). Univariate analysis revealed that F-score (13.6 ± 9.1 vs 7.4 ± 7.5, P = 0.001), imbalance grade(P= 0.014), male (70.4% vs. 39.8%, P = 0.004), smoking (40.7% vs.10.2%, P = 0.000) and low high density lipoprotein (HDL) cholesterol(47.7 ± 16.3 vs. 52 ± 13.8, p = 0.05) were associated with stroke. Inmultivariable analysis, imbalance grade only (p= 0.037) was associat-ed with stroke. Most common lesion in stroke patients with isolateddizziness was PICA territory.Conclusion: Those patients with isolated dizziness, imbalance gradecould be helpful to predict central origin.So prompt evaluations were needed to define stroke to thosepatients with high imbalance grade score presenting with dizziness.

doi:10.1016/j.jns.2013.07.836

Abstract — WCN 2013No: 1451Topic: 3 — StrokeIsolated right hand palsy due to cortical ischaemia

H. Yasara, V.S. Beka, R.E. Togralb. aNeurology, Ankara Mevki MilitaryHospital, Ankara, Turkey; bNeurology, GATA Haydarpasa EducationalHospital, Istanbul, Turkey

Case: 75 year old male patient with no known previous illness, noted aweakness on his right hand one day before his presentation to ourpolyclinic. He consulted the physical therapy and rehabilitationpolyclinic and an ENMG study was ordered with a preliminarydiagnosis of entrapment neuropathy. The ENMG was found to benormal, and a control ENMG was ordered 10 days later. The patientconsulted medical advice from the neurology polyclinic 1 day after thebeginning of his complaints. His neurological examination at the time ofhis application was as follows: Right hand fingers were in flexionposture, the motor strength of the opposition and flexion of the righthandfirst finger, abduction and adduction of the other fingers were 0/5.The strength of the right hand extension was 4/5. Hoffmann sign was(+) on the right side. The other neurological examination signs werenormal. Cranial MR imaging revealed widespread bilateral per-iventricular chronic lacunar ischaemia as well as an acute ischaemic

Abstracts / Journal of the Neurological Sciences 333 (2013) e152–e214e210