The Mexican geriatric population has grown significantly, leading to increased mortality rates, with IS identified as a primary cause. A thorough diagnostic evaluation is vital for accurately classifying etiologies, identifying risk factors, and guiding therapeutic interventions and prevention strategies.

We analyzed 168 patients, mean age of 75.9 years. The most prevalent risk factors were hypertension, diabetes, and atrial fibrillation. The average time from symptom onset to emergency department arrival was 22.3 ± 37.1 hours, with a registration-to-admission time of 16.7 ± 10.5 hours. The median NIHSS score was 12.5 ± 7.7.

All patients underwent electrocardiography, head CT was performed in 98.8%, echocardiography in 51.8%, MRI in 38.7%, carotid ultrasonography in 32.1%, 24-hour Holter monitoring in 30.4%, head CTA in 5.4%, and head MRA in 4.8%. IS were supratentorial in 85.1% and infratentorial in 14.9%. TOAST classification identified large artery atherosclerosis (13.1%), cardioembolism (25.6%), lacunar (3%), undetermined etiology (13.7%), and incomplete evaluation in 44.6%.

Regarding therapeutic interventions, 8.3% received tPA and 1.2% underwent thrombectomy. In-hospital mortality was 25.6%, while 30-day mortality was 7.1%.