Is Cerebral Ischemia An Inflammatory Disease? (Relation of acute phase reactant serum ferritin to prognosis of ischemic stroke)

Abstract

Recent work in the area of stroke and brain ischemia has demonstrated the significance of the inflammatory response accompanying necrotic brain injury. Acutely, this response appears to contribute to ischemic pathology, and anti-inflammatory strategies have become popular. Inflammation is among the targets of therapeutic interventions after stroke; thus, knowledge on its pathogenesis is of great value. This study represents an attempt to evaluate the relationship between acute ischemic stroke and inflammatory markers and relation of acute phase reactant serum ferritin to prognosis of ischemic stroke. Moreover, it studied the correlation between these inflammatory markers and serum ferritin on the one hand and the infarct size as well as the clinical outcome at 2 months follow up period on the other hand. Likewise, this study also assessed the value of the above mentioned inflammatory markers as prognostic factors of the stroke severity. This study was conducted on 60 patients with acute ischemic strokepresented at Ain Shams University hospitals; they were all subjected to the following: 1- Thorough history taking, general and neurological clinicalexamination. 2- Assessment of the stroke severity at 2 months follow up in stroke patients using the NIHSS. 3- Neuroimaging and measurement of the infarct size. 4- Routine battery of investigations. 5- Measurement of serum ferritin The results of this study revealed that: Correlation between age and prognosis of stroke There was non-significant correlation between age and cerebro-vascular stroke (CVS) as regards the severity and prognosis of CVS by NIHSS. Correlation between diabetes and prognosis of stroke There was non-significant correlation between diabetes and CVS as regards the severity and prognosis of CVS by NIHSS. Correlation between (HDL, LDL, cholesterol and triglesrids) and prognosis of stroke There was non-significant correlation between HDL , LDL , cholesterol and triglesrids and CVS as regards the severity and prognosis of CVS by NIHSS.

Correlation between RBCs and prognosis of stroke There was non-significant correlation between RBCs and CVS as regards the severity and prognosis of CVS by NIHSS. Correlation between WBCs and prognosis of stroke There was significant correlation between WBCs and CVS as regards the severity and prognosis of CVS by NIHSS. Correlation between ESR and prognosis of stroke There was non-significant correlation between ESR and CVS as regards the severity and prognosis of CVS by NIHSS. Correlation between HB and prognosis of stroke There was highly significant correlation between HB and CVS as regards the severity and prognosis of CVS by NIHSS. Correlation between Hct and prognosis of stroke There was non-significant correlation between Hct and CVS as regards the severity and prognosis of CVS by NIHSS