Title: A Study of Risk Factor and Clinical Manifestation in Patients with Ischemic Stroke

Authors: Vinod Kumar Mehta, Ayushi Jain, Rajesh Kumar Kori, Reena Chittora, Abbas Ali Mahdi

 DOI: https://dx.doi.org/10.18535/jmscr/v7i2.191

Abstract

Background: Cerebrovascular accident (CVA) is the major leading cause of death and disability in both developed and developing countries.  It is a neurological emergency and stroke patient should be taken immediately to a medical facility for diagnosis and treatment. The symptoms of a stroke depend mainly on the area of the brain that has been affected and the amount of tissue damaged.

Aim: The aim of this study was to investigate various clinical presentations in ischemic stroke patients.

Methods: A descriptive hospital-based study of the neurological symptoms and signs of 100 patients with ischemic stroke, including Glasgow Coma Scale (GCS), severe headache, cranial nerve palsy, aphasia, hemiplegia, monoplegia, ataxia, vertigo, eye movement disorder, were analyzed in the study.

Results: We analysed 100 patients having confirmed acute ischemic stroke. UMN types of facial nerve weakness were the most frequent presentation (88%).  But it was not found as an isolated presentation and usually associated with limb weakness, aphasia and other cranial nerve weakness.  The hemiplegia were the second most  frequent presentation (82%), in which left side hemiplegia were dominating (44%) as compared to 38 % in right side .Right side with aphasia were 18%  and without aphasia were 20% depending on  speech area involved. Pure aphasia without limb weakness was found in only 3 patients ( 3%). Total aphasia irrespective of limb weakness were found in 21 %.  Facio-brachial weakness found in 3 % cases while one patient (1%) had pure monoplegic type presentation. Five (5%) patients had acute ataxic manifestation, (5%) had lower cranial nerve involvement and one (1%) has internuclear ophthalmoplegia. Anterior circulation was involved in 62% case and remaining 38% had posterior circulation stroke. Low GCS (< 7) was found in 12 % case mainly in large anterior circulation or extensive brainstem involving stroke patients. Out of which 8% had mortality during hospital stay and remaining 4% were discharge with severe morbidity after prolonged hospital stay.

Conclusion: In the current study facial nerve palsy with limb weakness, acute onset hemiplegia, and aphasia had significantly higher prevalence in ischemic stroke patients.

Keywords: Ischemic Stroke, Nerve Palsy, Aphasia, Hemiplegia.

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Corresponding Author

Vinod Kumar Mehta

Assistant professor, Deapartment of Neurology, Geetanjali Medical University, Udaipur, 313001, India

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