Background: Stroke remains a major cause of human mortality and morbidity. Patients with stroke constitute 15- 20% of all admissions in medical college in spite of our increasing knowledge in the pathophysiology and epidemiology. Traditional risk factors like hypertension, diabetes obesity and smoking do not fully account for clinical occurrence of stroke in different population. Indeed atherosclerosis is accepted now as an inflammatory/infectious disease¹. William. Osler in 1908 proposed that infection could be a causal factor in pathogenesis of atherosclerosis. Various microorganisms had been implicated as a potential link between the inflammation and pathogenesis of atherosclerosis, possible infections include Pylori, CMV, Herpes Simplex and Chlamydia pneumonia .Researches found that C-reactive protein is elevated several years before the first episode of stroke. Ridker etal^2,3 in 1994 showed 3 fold increase in stroke in CRP elevated patients in a study of 1086 subjects.CRP measurement provide a novel method to detect worrisome level of atherosclerosis in otherwise normal patients. Antimicrobial and antiviral therapy may someday be a part of arsenal of therapy to prevent stroke.⁴ Limited studies are done in India correlating CRP with thrombotic stroke.

Objective

1.      To study the C-Reactive protein rise in thrombotic stroke in subjects without traditional risk factors.

2.      To identify existence of infection/inflammation in pathogenesis of stroke.

3.      To study the correlation of serology Ig GH.pylori infection in CRP positive stroke.

Materials and Methods: 200 subjects with first episode of stroke were taken for study. Subjects with CT proven thrombotic stroke without traditional risk factors were selected. These patients were evaluated for CRP levels (the study group). Age and sex matched normal control subjects were selected. All CRP positive stroke patient were screened for Ig-G H.Pylori.

Results: Out of 200 subjects with first episode of stroke 150 Subjects with CT proven thrombotic stroke were detected. Of the 150 subjects with CT proven ischemic stroke,80 pat ients were without traditional risk factors (the study group). In the semales constitute 60% and 22 were below age of 40(young stroke). CT findings showed majority of infarct were in basal ganglia and internal capsule. 64 out of 80 ischemic stroke patients had positive CRP (X²= 22.88, p <0.001). 42 out of 64CRP positive patients were found seropositive for Ig-G H.Pylori.

Conclusion: C-Reactive protein was significantly elevated in patients with thrombotic stroke without traditional risk factors. Strong correlation between CRP positivity and seroprevalence of IgG H.Pylori.

Keyword: CRP, atherosclerosis, thrombotic stroke, H.pyloriinfection.