Study of Clinico Radiological Profile of Ischemic Cerebrovascular Stroke and Its Outcome at Tertiary Care Centre

Authors

  • Vaishali Patel Associate Professor of Medicine, Medical College, Vadodara
  • Asha Vagadiya Tutor of Physiology, Medical College, Vadodara.

DOI:

https://doi.org/10.48165/2xpbwr17

Keywords:

Ischemic cerebrovascular stroke, Atherosclerotic risk factors

Abstract

Background: Ischemic CV stroke is disease of long term Disability and Death accounts for >80% of total stroke events. The main objective of  the study was to study clinical and radiological profile, risk factors and outcome of stroke. Subjects and Methods: An observational study of  46 patients of acute ischemic cerebrovascular stroke was conducted during January 2014 to November 2014. All patients were subjected to  Sociodemographic, Clinical, family h/o risk factors, dietary, other lifestyle habits and examination with written consent. Apart from routine  blood investigations, special investigations like Uric acid, urinary albumin creatinine ratio, ECG,2D Echo, Carotid Doppler, CT Scan/MRI  brain were done within24 hours of onset. NIHSS and MRS scores were used for severity assessment. Results: Majority of patients were in 55- 64 years (30.4%) age group with male predominance (52%) (mean age 55.52+12.61). Old aged patients are more likely to be selected for  study. Microalbuminuria was found on 34 (73.9%) Patients with recent stroke. 52.1 % patients having serum uric acid >8. 36.9 % patients.  ECG suggested LVH and normal findings in 36.9% while 15.2% and 10.8% had stroke related changes and myocardial ischemia. Majority 30 

(65%) of patients showed concentric hypertrophy, followed by diastolic dysfunction 11(23%) on 2D Echo. Atherosclerotic changes seen in  60.8% on carotid Doppler study. majority 32.6 % patients were affected in MCA territory, followed by 23.9 % PCA territory followed by  19.5% infarct in thalamus. NIHSS and MRSmean score was 20.2+ 12 and 3.9+1.8 on admission and 15.7+13 and 3.23+ 1.91 on discharge respectively. Hospital outcome was good. No mortality during entire study period. Conclusion: Stroke a high socioeconomic burden in  community. Apart from Age and hypertension, microalbuminuria and uric acid may be considered as independent risk factors for ischemic  stroke. Identification and treatment of risk factors can prevent stroke related morbidity and mortality. 

References

1. Hatano S. Experience from a multicenter Stroke Register,: A Preliminary Report, Bulletin WHO 1976;54:541-4.

2. Longo, Kasper, Hauser, Jameson, Loscalzo.Harrison’s Principles of Internal Medicine, 20 thediton, New York USA,:McGraw-Hill Companies;2018;vol 2, p-3068

3. Association of Physician of India(API), textbook of medicine,9th edition,vol2 ,page.1401.

4. Putaala J, Metso AJ, Metso TM, Konkola Y et al. Analysis of 1008 consecutive patients with first ever stroke, The Helnski young stroke registry.,Stroke 2009;vol 40(4):1195-1203.

5. Libre J, ValhuerdiA,Fernandez O. Prevalence of stroke and associated risk factors in older adults in Havana city and Matanzas Provinus, Cuba (10/66 population based study) MEDICC Review 2012;12;20- 24.

6. Rathmann W, Funkhouser E, Dyer AR, RosemanJM.The CARDIA (Coronary artery risk development in young adults)Study, Ann Epidemiol 1998;8;250-261.

7. Vivekjain, shaikhMks,siddhantjain and mukeshmeena .comparative study of serum vitamin D levels and other biomarkers in patients attending Tertiary cardiac care center.int. j.bioassays,2015;4(04);3812-14.

8. PutaalaJukka, Antti J,Metso, Tiina M. Metso, Nina Konkola, Yvonn Kraemer , Elena. Stroke: The Helsinki Young Stroke Registry 2010.DOI: 10.1161/ STROKEAHA.108.529883.

9. WojeiechTuraj et al. The prognostic significance of microalbuminuria in non-diabetic acute stroke patients. Med SciMonit 2001;7(5):989-994.

10. Slowik A et al. Microalbuminuria in non-diabetic acute stroke patients with acute ischemic stroke: Prevalence, clinical correlates and prognostic significance. Cerebrovascular Dis 2002;14(1):15-21.

11. Milinois, Haralampos J. et al “Serum uric acid levels and risk for acute ischemic nonembolic stroke in elderly subjects.” Journal of internal medicine. 258.5 (2005):435-441.

12. Milinois , H.J et al, “Risk factors for first ever acute ischemic non embolic stroke in elderly individuals” International journal of Cardiology 99.2 (2005):269-275.

13. Storhaug, Hilde M et al.Uric acid is a risk factor for ischemic stroke and all cause mortality in the general population:a gender specific analysis from The Tromso Study. BMC cardiovascular disorders 2013,13.1;115.

14. Mykkanen L et al.Microalbuminuria and carotid artery intima media thickness in non diabetic and NIDDM Subjects. The Insulin resistence Atherosclerosis Study (IRAS) Stroke 1997;28:1710-16.

15. Kumar G. Kalita B, Bansal V, Jain SK, Misra U. Magnetic resonance angiography findings in patients with ischemic stroke from north india.Stroke cerebrovascular Dis.2010 Mar 19(2): 146-52.

16. Dineshnayak , murlidharan, k. radhakrishnan. The national medical journal of indiavol 10,no.3,may 1997:10:107-12etal for athero changes in stroke.

17. CGumbinger, M.Sykora, J. Diedler, P. Ringleb, A. Rocco: Microalbuminuria : A potential prognostic marker for acute stroke:2012:83:1357-1360.

18. Cho BH, Kim JT, Chang J, Choi KH, Nam TS, Choi SM, Leee SH, Park MS.et al.Early clinical implications of microalbuminuria in patients with acute ischemic stroke.

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Published

2020-01-30

How to Cite

Study of Clinico Radiological Profile of Ischemic Cerebrovascular Stroke and Its Outcome at Tertiary Care Centre . (2020). Academia Journal of Medicine, 2(2), 159–162. https://doi.org/10.48165/2xpbwr17