Clinical Profile of Stroke

INTRODUCTION: Stroke is an emerging epidemic and is the third leading cause of death. The term stroke encompasses, Cerebral infarction, Intra cerebral hemorrhage, Cerebral venous thrombosis, Subarachnoid hemorrhage. Based on a retrospective analyses of subjects admitted in urban hospitals in India it was found that stroke constitutes nearly 2% of all hospital cases and 20% of neurological admissions. The incidence in younger population (below 40 years) is high (13 to 32%) when compared to European countries. A Random survey on 2,58,576 residents in urban areas of Vellore revealed only 147 hemiplegic subjects presumed to be Vascular origin. Thus the prevalence rate for hemiplegia in south India was reported to be 56.9 per 1,00,000 as compared 150 to 186 per 1,00,000 for USA and Europe. AIM OF THE STUDY: To study 200 cases of stroke with complete analysis of Age, Sex, Incidence, Types of stroke, other risk factors, Clinical presentation, Onset, Associated features, and CT scan findings. MATERIALS AND METHODS: 1. 200 cases of stroke in government Stanley medical college between September 2005 to February 2006. 2. Complete history, physical examination were done and clinical diagnosis of the patient was arrived. 3. All patients BP, bloodsugar, urea, serum creatinine, electrolytes, total cholesterol X ray chest, ECG, hemoglobin, total and differential count, and associated diseases were noted. 4. If associated diseases were noted further special work up was done. 5. CT brain plain was done for all patients . 6. Contrast enhancement CT brain was done as advised by radiologist. 7. MRI brain was done as advised by neurologist. 8. The results of all the data are expressed in the tabular forms for analysis. Excluded cases: Cerebral tumour, Cerebral abscess, Tuberculoma brain, Old CVA admitted for other diseases. CONCLUSION: Stroke commonly affecting males than females. More chance for getting stroke in the age group between 51 – 70 years. Young stroke was also commonly occurring. Ischemic stroke was more common than hemorrhagic stroke. Cerebral venous thrombosis occurred in the puerperial women No cases of subarachnoid hemorrhage in this study. Hypertension was the predominant risk factor. DM was also present. Hypercholesterolemia was associated with in patients with ischemic stroke. Smoking, alcoholism, and obesity were also important risk factor. Onset of stroke was sudden in most of the cases. Stroke developed while on Activities of daily living, then stress Hemiplegia or hemiparesis was the commonest presentation. Loss of consciousness, Bladder / bowel involvement, UMN type Facial palsy, Aphasia was commonly associated features. Patients were also presented with TIA symptoms. Stroke patients had cardiac lesions like IHD, RHD, DCMP, MVP, Aortic sclerosis. Various medical diseases also were present in stroke patients also. Stroke caused by Cerebral venous thrombosis commonly occurred in the young females in puerperial period. In imaging studies, Cerebral infarction was the common finding. Others were Cortical atrophy, Multiple infarct. Some patients showed normal studies