Retrospective analysis of patients diagnosed with ischemic cerebrovascular event presenting to the emergency department

Objective: This study retrospectively analyzes the demographics, risk factors, clinical findings, etiology, and treatments of patients diagnosed with ischemic cerebrovascular event (CVE) at Cerrahpaşa Faculty of Medicine Emergency Department between 2020 and 2024. Materials and Methods: 517 patients were included. Data were obtained from hospital records and etiological classification was performed using TOAST criteria. Admission times, NIHSS scores, and acute treatments (antiplatelets, anticoagulants, thrombolytics, and mechanical thrombectomy) were analyzed. Results: The cohort was 58.6% male and 41.4% female; the median age of females was significantly higher. Primary risk factors included hypertension (58.2%), diabetes mellitus (31.9%), and coronary artery disease (26.1%). Notably, 83% of patients arrived more than 4.5 hours after symptom onset. According to TOAST classification, small vessel disease was the most frequent subtype (29.7%). Despite high hypertension and diabetes prevalence in the small vessel group, medication adherence was low (27.2% and 13.2%, respectively). Only 4.3% received thrombolytic therapy and 2.8% underwent mechanical thrombectomy. Conclusion: Small vessel disease was the most common etiological subtype, strongly associated with uncontrolled hypertension and diabetes. The high rate of late hospital presentations and the prevalence of small vessel disease significantly limit the feasibility of acute reperfusion therapies. These findings emphasize the necessity of enhancing public stroke awareness and improving chronic disease management. Keywords: Ischemic stroke, emergency department, TOAST classification, small vessel disease, admission time.