Details
Category: Volume 07 Issue 03 March 2019
Hits: 1183

Title: Neurological manifestation in patients with hemorrhagic and ischemic stroke: a study in Indian population

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

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.26

Abstract

Background: The two types of brain stroke are hemorrhagic and ischemic. The symptoms that follow a stroke aren't significant and depend on the brain area affected and damaged. Parameters for predicting long-term outcome in such patients have not been clearly defined. This study was undertaken to predict the neurological manifestations and outcomes of stroke patients.

Methods: A descriptive hospital-based study of the neurological symptoms and signs of 60 patients with stroke, including headache, seizure, eye movement disorder, pupil size, Glasgow Coma Scale (GCS), nerve palsy, aphasia, hemiplegia, monoplegia, ataxia, vertigo, were analyzed.

Results: In the present study, dilated pupils, agitation, severe headache, lower GCS score, seizure, and eye gaze impairment had significantly higher prevalence in hemorrhagic stroke patients (P<0.001) as compared to ischemic stroke patients.

Conclusion: Although this result provides different parameters for the stroke types, imaging studies are still the gold standard modality for diagnosis.

Keywords: Stroke, ischemic, hemorrhagic, clinical presentation, seizure.

References

  1. Murray C, Lopez A. Cambridge, MA: Harvard University Press; 1996. Global health statistics: A compendium of incidence, prevalence and mortality estimates for over 200 conditions.
  2. Strong K, Mathers C, Bonita R. Preventing stroke: Saving lives around the world. Lancet Neurol. 2007;6:182–7. 
  3. Strong K, Mathers C. The global burden of stroke. In: Mohr JP, Grotta JC, Wolf PA, Moskowitz MA, Mayberg MR, Von Kummer R, editors. Stroke: Pathophysiology, Diagnosis and Management. 5th ed. Philadelphia, PA: Elsevier; 2011. pp. 279–89.
  4. Feigin VL, Lawes CMM, Bennett DA, Barker-Collo SL, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: A systematic review. Lancet Neurol. 2009;8:355–69.
  5. Williams GR, Jiang JG, Matchar DB, Samsa GP. Incidence and occurrence of total (first-ever and recurrent) stroke.  Stroke. 1999;30(12):2523–8. 
  6. Kolominsky-Rabas PL, Sarti C, Heuschmann PU, Graf C, Siemonsen S, Neundoerfer B, et al. A prospective community-based study of stroke in Germany—the Erlangen Stroke Project (ESPro):incidence and case fatality at 1, 3, and 12 months. Stroke. 1998;29(12):2501–6.
  7. Smith RW, Scott PA, Grant RJ, Chudnofsky CR, Frederiksen SM. Emergency physician treatment of acute stroke with recombinant tissue plasminogen activator:a retrospective analysis. Acad Emerg Med. 1999;6(6):618–25. 
  8. Lewandowski CA, Frankel M, Tomsick TA, Broderick J, Frey J, Clark W, et al. Combined intravenous and intra-arterial r-TPA versus intra-arterial therapy of acute ischemic stroke:Emergency Management of Stroke (EMS) Bridging Trial. Stroke. 1999;30(12):2598–605. 
  9. Brott T, Adams HP, Jr, Olinger CP, Marler JR, Barsan WG, Biller J, et al. Measurements of acute cerebral infarction:a clinical examination scale. Stroke. 1989;20(7):864–70. 
  10. PN Sylaja, JD Pandian, S Kaul, MVP Srivastava… Ischemic stroke profile, risk factors, and outcomes in India: The indo-US collaborative stroke project - Stroke, 2018 – Am Heart Assoc.
  1. WHO MONICA Project Principal Investigators. The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease) J Clin Epidemiol. 1988;41:105–14.
  2. Caplan LR. Basic pathology, anatomy, and pathophysiology of stroke. In: Caplan’s Stroke: A clinical approach, 4thed, Saunders Elsevier, Philadelphia 2009. P22.
  3. Kase CS, Caplan LR. Intracerebral hemorrhage. Lancet 1992; 229:656.
  4. Tsai CF, Thomas B, Sudlow CL. Epidemiology of stroke and its subtypes in Chinese vs white populations: a systematic review. Neurology. 2013;81:264–272.
  5. Sridharan SE, Unnikrishnan JP, Sukumaran S, Sylaja PN, Nayak SD, Sarma PS, et al. Incidence, types, risk factors, and outcome of stroke in a developing country: the Trivandrum Stroke Registry. Stroke. 2009; 40: 1212–1218.
  6. Ojaghihaghighi S, Vahdati SS Mikaeilpour A, Ramouz A.et al, Comparision of the  neurological clinical manifestation in patients with hemorrhagic and ischemicstroke. World J Emerg Med. 2017;8(1):34-38. 
  1. Besson G, Robert C, Hommel M, Perret J. Is it clinically possible to distinguish nonhemorrhagic infarct from hemorrhagic stroke? Stroke. 1995;26(7):1205–9.
  2. Celani MG, Righetti E, Migliacci R, Zampolini M, Antoniutti L, Grandi FC, et al. Comparability and validity of two clinical scores in the early differential diagnosis of acute stroke. BMJ. 1994;308(6945):1674–6.

Corresponding Author

Dr Vinod Kumar Mehta

Assistant Professor, Dept of Neurology, Geetanjali Medical University (GMCH), Udaipur, 313001, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.