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Category: Volume 07 Issue 11 November 2019
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Title: A study of risk factors and clinical profile of patients with cerebrovascular stroke

Authors: Dr B Suryanarayana,  Dr Tirupati Reddy Chirra

 DOI: https://dx.doi.org/10.18535/jmscr/v7i11.70

Abstract

Background: Cerebrovascular accident or Stroke is the leading cause of morbidity and mortality in adults. Ischemic stroke is the commonest type of stroke found across the world. The clinical presentation may vary depending on the site of involvement and major etiological factors identified showed hypertension, dyslipidemia, and smoking. We in the present study tried to evaluate the profile of patients with cerebrovascular stroke in a tertiary care hospital.

Methods: This prospective cross-sectional study was conducted in the Department of General Medicine, Govt. Medical College and Hospital Nalgonda. During the study period, n=50 patients were studied based on the inclusion and exclusion criteria. A detailed general examination was carried out. A comprehensive Neurological examination including fundoscopy was done. The patients were subjected to CT scanning and other biochemical investigations.

Results: During the study period n=50 patients were studied based on the inclusion and exclusion criteria Out of n=50 patients n=32 (64%) were male and n=18(36%) were female patients. The major risk factors for Cerebrovascular stroke appears to be Hypertension with n=32(64%). 80% of patients presented with the features of motor weakness that included hemiplegia/hemiparesis. Among them, 58% were right-sided weakness and 42% were with left-sided weakness. N=25(50%) of patients with speech involvement that included dysarthria and aphasia. ischemic infarct was commonly found in the parietal region (33.33%), hemorrhagic infarct was found more frequently in the parietal region & basal ganglia in 21.43%.

Conclusion: This study concluded that ischemic stroke is one of the common than hemorrhagic stroke. Age and male sex are non-modifiable risk factors for cerebrovascular stroke. The modifiable risk factors are hypertension, diabetes mellitus, and hyperlipidemia. Therefore the early diagnosis of blood pressure and its strict control can reduce the burden of stroke in this group of population.

Keywords: cerebrovascular stroke, Risk Factors, clinical profile.

References

  1. Hartona. Experiences from a multicentre stroke register: a preliminary report. Bull WHO. 1976; 54(5):541-53.
  2. Stroke in developing countries: Epidemiology, Impact, Policy Implications. Development policy review 2010; 28(6):693-709.
  3. Nagaraja D, Gururaj G, Girish N, Panda S, Roy AK, Sharma GRK et al. Feasibility study of stroke surveillance: Data from Bangalore, India. Indian J Med Res. 2009 Oct; 130: 396-403.
  4. Dalai PM, Shah PM, Aiyar AR, Kikani BJ. Cerebrovascular disease in west Central India. A report of angiographic findings from a prospective study. Brit Med J. 1968; 3: 769-774.
  5. Feigin V, Lawes C, Bennet D, Barker-Cello S, Parag V. Worldwide stroke incidence and early case fatality in 56 population-based studies: A systematic review. Lancet neurology. 2009; 8(4): 355-69.
  6. Mac Mahon S, Peto R, Cutler J, Collins R, Sorlie P, Neaton J et al. Blood pressure, stroke, and coronary heart disease, part 1: prolonged differences in blood pressure: prospective observational studies corrected for the regression dilution bias. Lancet. 1990; 335: 765–74.
  7. Burt VL, Whelton P, Roccella EJ, Brown C, Cutler JA, Higgins M et al. Prevalence of hypertension in the US adult population: results from the Third National Health and Nutrition Examination Survey, 1988–1991. Hypertension. 1995; 25: 305–13.
  8. Veterans Administration Cooperative Study Group on Antihypertensive Agents. Effects of treatment on morbidity in hypertension, II: results in patients with diastolic blood pressure averaging 90 through 114 mm Hg. JAMA. 1970; 213: 1143–52.
  9. Kool MJ, Hoeks AP, Struijker Boudier HA, Reneman RS, Van Bortel LM. Short- and long-term effects of smoking on arterial wall properties in habitual smokers. J Am Coll Cardiol. 1993; 22: 1881–86.
  10. Joshi R. Cardona M, Iyengar S, Sukumar A, Raju CR, Raju K, et al. Chronic disease now a leading cause of death in rural India-mortality data from the Andhra Pradesh rural health initiative. Intern J of Epi. 2006; 35: 1522-29.
  11. Sethi P, Anand I, Ranjan R, Sethi N, Torgovnick J. Stoke: the neglected epidemic: an Indian perspective. Internet J of Neur. 2007;8(1): 1-8.
  12. Shah B, Mathur P. Workshop Report on Stroke Surveillance in India. Division of Non-communicable Diseases. New Delhi: Indian Council of Medical Research; 2006.
  13. Aiyar et al. A study of clinic-radiological correlation in cerebrovascular stroke (A study of 50 cases). Guj Med J. 1999; 52:58-63.
  14. Naik M, Rauniyar RK, Sharma UK, Dwivedi S, Karki DB, Samual JR. Clinic-radiological profile of stroke in eastern Nepal: A computed tomographic study. Kathmandu University of medical council. 2006;4(14): 161-66.
  15. Pinheiro L, Damodar S, Roy AK. Risk factors in stroke: a prospective study. J Assoc Physician India. 2000 Jan; 48:72-76.
  16. Banerjee TK, Mukharjee CS, Sarkhel A. Stroke in the urban population of
    Calcutta–An epidemiological study. Neuroepidemiology 2001: 2(3):201-07.
  17. Kannel WB, McGee DL. Diabetes and cardiovascular disease: the Framingham Study. JAMA. 1979; 241: 2035–38.
  18. P. Eapen, J. H. Parikh, N. T. Patel. A study of clinical profile and risk factors of cerebrovascular stroke. Guj Med J. 2009; 64(2):47-54.
  19. Abdul-Rahman Sallam, Khalid Al-Aghbari. The clinical profile of stroke: a Yemeni experience. J Med J. 2009; 43(2):115-21.
  20. Kaur IR, Agarwal MP, Singh NR. Study of clinical profile & CT correlation in CV stroke. J Assoc Physician India. 2001; 51:112-17.
  21. Devichand, Karoli RK. A study of cerebrovascular strokes. J Indian Med Assoc. 1991 Jan; 36(12):62-65.

Corresponding Author

Dr Tirupati Reddy Chirra

Associate Professors, General Medicine, Government Medical college, Nalgonda, Telangana