Title: Clinical Profile & Circadian Variation in Onset of CVA in Tertiary Care Hospital
Authors: Dr S.V. Biradar, Dr Swati Nagnathrao Patil
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.179
Abstract
Introduction: Stroke or CVAs include some of the most common and devastating disorders. Most CVAs manifest by the abrupt onset of a focal neurologic deficit. Cerebral ischemia is caused by a reduction in blood flow that lasts longer than several seconds and has a peculiar distribution along the day , week & even months of the year. Various patterns of circadian onset variation have been reported in literature.
Materials and Methods: 200 patients were taken for study from December 2016 to November 2018, study conducted prospectively in all patients with clinical diagnosis of stroke who fulfilled the eligibility criteria. The local ethics committee approved the trial protocol and verbal informed consent was obtained from all the patients or their relatives as applicable. The patients were subdivided into two groups based on the etiology of CVA: Group 1 (infarct) and Group 2 (hemorrhage). The time of presentation was divided into 6 sections of four hour interval starting from 00.01 hrs (12:01 am midnight).
Result: Mean age of the study subjects was 57.8 years. Male predominance was seen among study. Unilateral hemiplegia was the most common presenting complaint (94%). Out of the total 200 cases of stroke, 65.5% were ischemic stroke while remaining 34.5% were haemorrhagic stroke. Most common associated risk factors were hypertension (60.5%), alcohol (40.5%), smoking (45%). ECG changes were seen in 54% cases. Most common time of occurrence of stroke was early morning hours i.e. between 4am to 12 noon (57%). Only 11.5% stroke patients present during the night hours i.e. 8pm to 4am. No significant association was observed between type of stroke and diurnal variation (p-0.22). Most common time of occurrence of stroke was early morning hours in both hemorrhagic and ischemic stroke.
Conclusion: Our study confirms that stroke as many other cardiovascular diseases occurs preferentially during waking and in the morning irrespective of the stroke subtype.
Keywords: CVA (cerebro vascular accidents).
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