Jerrin Thomas 1 , Devasena Srinivasan 2 , S. Manjunath 3 , Swathy Moorthy 4 , S. Kavitha 5
ABSTRACT: BACKGROUND: Acute ischemic stroke is very common cause of significant morbidity and mortality throughout the world. The causes of acute ischemic stroke could be intracranial or extra cranial. Prevention of the acute episode could be decreased by surgically treating extra-cranial vascular disease but the prevention of intracranial cause is only medical. Various risk factors are also associated with development of ischemic stroke. However, the association between these and the pattern of vascular involvement is not clear. AIM: The aim of the study was to 1. Identify the location of the vessel involved in different cases of ischemic stroke 2. To study the various risk factors associated with the development of ischemic stroke. MATERIALS AND METHODS: This was a prospective study conducted between the years 2010 and 2012. All adult patients with acute ischemic stroke which was confirmed by MRI and less than two weeks duration were included in the study. Parameters recorded were presence of pre-existing comorbid conditions, neurological examination findings, Cardiovascular system examination findings, Blood pressures, blood sugar levels and pattern of vascular involvement. This was assessed using MR angiography or four vessel Doppler. Statistical analysis was done using the SPSS software. RESULTS: Two hundred patients were enrolled in the study. Pure extracranial stenosis was present in 21.5%, extracranial with intracranial stenosis in 34%, and pure intracranial stenosis in 44.5%, which was predominant and resembled other Indian studies. 15.5% of patients had significant carotid stenosis based on Doppler study and were suitable candidates for carotid endarterectomy. Middle cerebral artery was commonly involved (55%). Hypertension (63.5%), diabetes mellitus (48%), alcoholism (20.5%) and smoking (18.5%) were the common risk factors. Prevalence of these risk factors was more in those with intracranial stenosis in our study, elevated total cholesterol, LDL, triglyceride and low HDL showed no relation to the incidence of ischemic stroke. CONCLUSION: The vascular and demographic patterns in ischemic stroke help us to identify modifiable risk factors which can prevent the development of acute stroke.