Non-traumatic cervicomediastinal vascular lesions. A clinicopathological study in the different populations of Natal.

Apart from those suffering from vascular trauma, 334 patients with cervicomediastinal lesions have been treated at Durban Metropolitan Hospitals over a period of 8 years. Sixty-seven of these were black (20%), 79 Indian (24%), 10 coloured (3%) and 178 white (53%). Atherosclerotic disease was found in 50% of black, 80% of Indian and 99% of white patients; the remaining patients suffered from miscellaneous conditions, such as arteritis, fibromuscular dysplasia, mucoid degeneration and radiation. Aneurysmal disease was found in 33% of blacks, but only 2% of Indians and 0.6% of whites; the remainder had occlusive lesions. More blacks presented with complete stroke (16%) than in the other population groups, who presented most frequently with episodic neurological dysfunction. It is concluded that atherosclerosis is as common as arteritis in blacks, while it is the most common precipitating factor for cervicomediastinal lesions in the other two groups. Aneurysms and complete stroke are also common in blacks.