Title: Risk Factors, Vascular Lesion Distribution and Outcome of Strokes Due to Intracranial Atherosclerosis in rural south India

Authors: Dr C. Sundararajan, Dr A. Rajendran, Dr M.Thangaraj, Dr M. Arun Kumar, Dr J. Alwine Leonard Dani

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.186

Abstract

Background: Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke worldwide and probably in India.. The common risk factors for development of intracranial atherosclerosis include hypertension, diabetes, tobacco use and hyperlipidemia. The morbidity and mortality associated with ischemic stroke makes it essential that individuals with risk factors must be identified and appropriate interventions must be done to prevent stroke.

Aim:  The aim of this study was to describe the risk factors, distribution of vascular lesions and outcome of stroke due to ICAS.

Methodology:  All consecutive patients of ischemic stroke due to ICAS were enrolled prospectively on the basis of a predefined inclusion and exclusion criteria. Demographic details and history of systemic illnesses particularly diabetes and hypertension was noted in all the cases. Vascular territory involved was determined on the basis of imaging (computerized tomography, Magnetic resonance imaging and MR angiography. Details about, risk factors, vascular lesions and outcome were noted. Data was examined using SSPE 16.0 software. For statistical purposes p value less than 0.05 was taken as statistically significant.

Result: Out of 455 patients there were 328 (72.09%) males and 127 (27.91%) females with a M:F ratio of 1:0.38. The most common age group affected in males and females was 61-70 years (M-29.45%, F-11.42%) followed by 51-60 years (25.93%) in males and more than 70 years (9.89%) in females.The difference in mean age of males and females was found to be statistically ‘highly significant’.The most common risk factors associated with stroke was hypertension (54.29%) followed by diabetes mellitus (51.43%).Middle cerebral artery was involved in majority of the cases (n-299, 65.71%). Mean duration of hospital stay was found to be 9.81 +/- 7.17 days. Mortality rate was found to be 11.65%.

Conclusion: Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke Identification of risk factors and their management remains the best strategy for preventing recurrence.

Keywords: Intracranial atherosclerosis, Ischemic stroke, Middle cerebral artery, Risk Factors.

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Corresponding Author

Dr. A. Rajendran, M.D., D.M.

Assistant Professor, Department of Neurology, Govt. Thanjavur Medical College Thanjavur, India