Study on Causes of Ischemic Stroke Recurrence in a Sample of Egyptian Population
Ahmed Mohammed Anany;
Abstract
The aim of the present work was to identify risk factors in different subtypes of recurrent ischemic stroke and to correlate between clinical presentation and radiological findings in each of the previous stroke subtypes.
The material of the present work consisted of 100 patients with acute ischemic cerebrovascular stroke admitted to the stroke unit at El-Demerdash university hospital and Al-Sahel teaching hospital. The mean age was 66.82 15.862 years with a range from 20-85 years. There were 44 (44%) females and 56 (56%) males.
All patients were subjected to complete history, thorough clinical examination and neurological assessment, laboratory investigations including routine investigations and antinuclear antibody, antidouble stranded DNA antibody and anticardiolipin antibody were performed when indicated, imaging including plain X-ray chest, CT and/or MRI pain, and transthoracic echocardiography, Doppler examination of carotid and vertebral arteries, cerebral angiogram when indicated.
The patients were subdivided into four main groups according to neuro-imaging (CT and/or MRI):
Group A (cortical and large subcortical infarctions 54 patients (54%), B (cortical and lacunar infarctions 26 patients (26%), C (cortical, large subcortical and lacunar infarctions 18 patients (1810%) and D (large subcortical and lacunar infarctions 2 patients (2%) and revealed the following:
1. As regard the demographic data, including age, sex, there were no statistical differences in all groups.
2. There were no statistical differences in all groups as regard mean body mass index, personal and family histories of previous stroke, and carotid artery disease.
3. There were no statistically significant differences as regard high blood pressure in four groups.
4. No statistically significant differences were found, as regard mean systolic and mean diastolic blood pressure in four groups but The mean duration of hypertension was higher in group c (Cortical, large subcortical and lacunar).
5. As regard cardiac problems, there was no difference between ischemic stroke subtypes as regard past and family history of heart attack, history of and personal and family history of other heart disease (e.g. rheumatic heart disease).
6. As regard atrial fibrillation, there was a statistically significant difference in which it was higher group A (cortical, large subcortical infarctions).
7. There were no statistically significant differences as regard personal and family history of diabetes mellitus, type and mean duration of diabetes mellitus, and mean random blood sugar on admission in groups.
8. As regard mean fasting blood sugar, there was a statistically significant difference in which it was higher group C (cortical, large subcortical and lacunar).
9. There were no statistically significant differences as regard personal and positive family history of high blood cholesterol, mean serum cholesterol, triglyceride, high density lipoprotein, and low density lipoprotein levels.
10. There were no statistically significant differences between ischemic stroke subtypes in four groups as regard smoking, number of packs smoked per day and smoking duration.
11. There was four cases who consumed alcohol. So, there was no significant correlation between alcohol consumption and ischemic stroke recurrence.
12. There was a statistically significant difference as regard mean red blood cells count, being higher in group C (cortical, large subcortical and lacunar). There was a statistically significant difference as regard mean haemoglobin concentration , being higher in group B (cortical and large subcortical). There was a statistically significant difference as regard mean haematocrete being higher in group B (cortical and large subcortical). There was a statistically significant difference as regard mean white blood cells count, being higher in group B (cortical and large subcortical). There was no significant difference as regard mean platelets count in our studied groups.
13. There were no statistically significant differences between recurrent ischemic stroke subtypes as regard renal function tests, liver function tests, and serum uric acid level.
In conclusion, Group C (cortical, large subcortical and lacunar infarctions) were more related to high fasting blood sugar and high mean red blood cell count and mean duration of hypertension. And in group B (cortical and lacunar infarctions) the mean haemoglobin concentration, mean hematocrete and mean white blood cell count were higher but in Group A (cortical, large subcortical infarctions) atrial fibrillation was higher.
The material of the present work consisted of 100 patients with acute ischemic cerebrovascular stroke admitted to the stroke unit at El-Demerdash university hospital and Al-Sahel teaching hospital. The mean age was 66.82 15.862 years with a range from 20-85 years. There were 44 (44%) females and 56 (56%) males.
All patients were subjected to complete history, thorough clinical examination and neurological assessment, laboratory investigations including routine investigations and antinuclear antibody, antidouble stranded DNA antibody and anticardiolipin antibody were performed when indicated, imaging including plain X-ray chest, CT and/or MRI pain, and transthoracic echocardiography, Doppler examination of carotid and vertebral arteries, cerebral angiogram when indicated.
The patients were subdivided into four main groups according to neuro-imaging (CT and/or MRI):
Group A (cortical and large subcortical infarctions 54 patients (54%), B (cortical and lacunar infarctions 26 patients (26%), C (cortical, large subcortical and lacunar infarctions 18 patients (1810%) and D (large subcortical and lacunar infarctions 2 patients (2%) and revealed the following:
1. As regard the demographic data, including age, sex, there were no statistical differences in all groups.
2. There were no statistical differences in all groups as regard mean body mass index, personal and family histories of previous stroke, and carotid artery disease.
3. There were no statistically significant differences as regard high blood pressure in four groups.
4. No statistically significant differences were found, as regard mean systolic and mean diastolic blood pressure in four groups but The mean duration of hypertension was higher in group c (Cortical, large subcortical and lacunar).
5. As regard cardiac problems, there was no difference between ischemic stroke subtypes as regard past and family history of heart attack, history of and personal and family history of other heart disease (e.g. rheumatic heart disease).
6. As regard atrial fibrillation, there was a statistically significant difference in which it was higher group A (cortical, large subcortical infarctions).
7. There were no statistically significant differences as regard personal and family history of diabetes mellitus, type and mean duration of diabetes mellitus, and mean random blood sugar on admission in groups.
8. As regard mean fasting blood sugar, there was a statistically significant difference in which it was higher group C (cortical, large subcortical and lacunar).
9. There were no statistically significant differences as regard personal and positive family history of high blood cholesterol, mean serum cholesterol, triglyceride, high density lipoprotein, and low density lipoprotein levels.
10. There were no statistically significant differences between ischemic stroke subtypes in four groups as regard smoking, number of packs smoked per day and smoking duration.
11. There was four cases who consumed alcohol. So, there was no significant correlation between alcohol consumption and ischemic stroke recurrence.
12. There was a statistically significant difference as regard mean red blood cells count, being higher in group C (cortical, large subcortical and lacunar). There was a statistically significant difference as regard mean haemoglobin concentration , being higher in group B (cortical and large subcortical). There was a statistically significant difference as regard mean haematocrete being higher in group B (cortical and large subcortical). There was a statistically significant difference as regard mean white blood cells count, being higher in group B (cortical and large subcortical). There was no significant difference as regard mean platelets count in our studied groups.
13. There were no statistically significant differences between recurrent ischemic stroke subtypes as regard renal function tests, liver function tests, and serum uric acid level.
In conclusion, Group C (cortical, large subcortical and lacunar infarctions) were more related to high fasting blood sugar and high mean red blood cell count and mean duration of hypertension. And in group B (cortical and lacunar infarctions) the mean haemoglobin concentration, mean hematocrete and mean white blood cell count were higher but in Group A (cortical, large subcortical infarctions) atrial fibrillation was higher.
Other data
| Title | Study on Causes of Ischemic Stroke Recurrence in a Sample of Egyptian Population | Other Titles | أسباب تكرار السكتة الدماغية اِلإقفارية في عينة من المصــــريـين (دراســــة استعاديــــة) | Authors | Ahmed Mohammed Anany | Issue Date | 2017 |
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