A study of clinical profile and factors associated of cerebro-vascular stroke

 

D Bhargava¹, B Phaninder Reddy^2*

 

¹Assistant Professor, Department of Medicine, Viswabharathi Medical College and Hospital, Penchikalapadu, Kurnool, INDIA.

²Assistant Professor, Department of Medicine, RVM Medical College, Village Laxmakkapaly, Mdl Mulugu, Dist Siddipet, Telangana, INDIA.

Email: bhargava.dinni@gmail.com

 

Abstract Background: Stroke or Cerebrovascular diseases include some of the most common and devastating disorders: ischemic stroke, hemorrhagic stroke, and cerebrovascular anomalies such as intracranial aneurysms and Arteriovenous Malformations (AVMs). Aims and Objectives: to Study clinical profile and factors associated of Cerebro-vascular stroke. Methodology: This was a hospital based cross-sectional study in the patients admitted with cere brovascular accidents (CVA) at the department of Medicine of a tertiary health care centre during the one year period i.e. January 2016 to January 2017. During the one year period there were 44 patients admitted these patients under gone through clinical and anthropometric examination and investigations like MRI/ CT Brain, CBC, and other routine investigations. Result : The majority of the patients were in the age group of >80 were 29.55%, followed by 60-70 - 25.00%, 50-60 were 20.45%, 40-50 were 15.91%, 30-40 were 9.09%. The majority of the patients were Male i.e. 61.36 and Females were 38.64. The majority of the patients were having Embolic i.e. 34.09%, Thrombotic - 27.27%, Hemorrhagic - 20.45%, Cortical venous sinus thrombosis (CVTS) in 18.18% type of the stroke. The majority of the patients complained of Headache in 94%, Slurred words and difficulty understanding speech in 90%, Numbness, weakness or paralysis in face, arm or leg etc. In 80% trouble with seeing in one or both eyes in 60%, Trouble with walking in 50% of the patients. The majority of the patients associated with Age > 50 were 75.00 %, followed by K/C/O Diabetes in 56.82%, followed by Obesity (BMI >30) in 47.73%, K/C/O Hypertension in 43.18%, H/O Smoking in 38.64%, H/O Alcohol intake in 27.27%, Hyper-lipedemia in 20.45%. Conclusion: It can be concluded from our study that majority of the associated factors were Age > 50, Diabetes, Obesity (BMI >30),Hypertension, Smoking, Alcohol intake, Hyperlipedemia.

Key Words: Cerebro-vascular stroke (CVA), Obesity (BMI >30), Risk factors of Stroke, Hyperlipedemia.

 

INTRODUCTION

Stroke or Cerebrovascular diseases include some of the most common and devastating disorders: ischemic stroke, hemorrhagic stroke, and cerebrovascular anomalies such as intracranial aneurysms and Arteriovenous Malformations (AVMs). Most cerebrovascular diseases manifest by the abrupt onset of a focal neurologic deficit, as if the patient was “struck by the hand of God.” According to the Global Health Observatory (GHO), stroke is the second most common cause of death during last decade (2000-2011) with a rising trend¹. A stroke, or cerebrovascular accident, is defined by this abrupt onset of a neurologic deficit that is attributable to a focal vascular cause².  Thus, the definition of stroke is clinical, and laboratory studies including brain imaging are used to support the diagnosis. The clinical manifestations of stroke are highly variable because of the complex anatomy of the brain and its vasculature. The effects of stroke can vary enormously, depending on the area of brain that has been damaged and the extent of the damage. Clinical Features varies from paralysis communication difficulties (problems with speaking, reading, writing and understanding) difficulties with mental processes, such as learning, concentration and memory. Some patients can present with visual disturbances, urinary incontinence, swallowing difficulties and emotional problems etc. It can take time for the full implications of a stroke to sink in. It has physiological, economical and psychological impact on the patients³.  Stroke ranks first amongst all CNS diseases both in frequency and gravity. Approximately 20 million people each year suffer from stroke and of these 5 million do not survive⁴.  Older population based studies in India conducted in Vellore and Rohtak quoted annual incidene of Stroke as 13 per lac and 33 per lac persons respectively^5,6. Strokes form nearly 1.5% of all hospital admissions, 4.5% of all medical and 20% of neurological cases⁷.  Although stroke is considered to be the disease of older population, the with demographic shift the disease incidence is shifting to younger age group. It is not infrequent among adolescent and young adults (Age 15-45 yrs).

 

MATERIAL AND METHODS

This was a hospital based cross-sectional study in the patients admitted withcere brovascular accidents (CVA)at the department of Medicine of atertiary health care centre during the one year period i.e. January 2016 to January 2017.  During the one year period there were 44 patients admitted these patients under gone through clinical and anthropometricexamination and investigations like MRI/ CT Brain, CBC, and other routine investigations. All details of the patients like Age, sex, clinical features and associated factors if any were recorded. The data was presented in the tabular form and expressed in percentages.  

 

RESULT

 

Table 1:Distribution of the patients as per the age

The majority of the patients were in the age group of >80were 29.55%, followed by 60-70 25.00%, 50-60were 20.45%, 40-50were 15.91%, 30-40were 9.09%.

 

Table 2: Distribution of the patients as per the sex

The majority of the patients were Male i.e. 61.36 and Females were 38.64.

 

Table 3: Distribution of the patients as per the type of stroke

The majority of the patients were having Embolic i.e. 34.09%, Thrombotic - 27.27%, Hemorrhagic - 20.45%, Cortical venous sinus thrombosis (CVTS)in 18.18% type of the stroke.

Table 4: Distribution of the patients as per the clinical features

The majority of the patients complained of Headachein 94%, Slurredwordsanddifficulty understanding speechin90%, Numbness, weakness or paralysis in face, arm or leg etc.In 80% trouble with seeing in one or both eyes in 60%, Trouble with walkingin 50% of the patients.

 

Table 5: Distribution of the patients as per the associated factors

The majority of the patients associated with Age > 50were 75.00 %,  followed byK/C/O Diabetesin 56.82%, followed byObesity (BMI >30)in 47.73%,K/C/O Hypertensionin 43.18%,H/O Smokingin 38.64%,H/O Alcohol intakein 27.27%, Hyper-lipedemiain 20.45%.

 

DISCUSSION

Strokeisadevastatinganddisablingcerebrovasculardisease with significant amount of residual deficit leadingontoeconomicloss.Ithasbeendefinedasarapidlydevelopingsignsoffocal(orglobal)disturbanceofcerebral function with symptoms lasting for ≥24 hours, orleadingtodeathwithnoapparentcauseotherthanvascularorigin.⁸Itisacollectionofclinicalsyndromesresultingfromcerebralischemiatointracranialhemorrhage. In the west, it is the 3rd most common causeof morbidity and mortality. ⁹Someoftherecentstudieshaveelucidatedthestrokepatterntoconsiderableextentinourcountrywithaprevalenceratpopulation.¹⁰Recentstudyidentifiedthat7%ofmedicaland45%ofneurological admissions were due to stroke with a fatalityrateof9%athospitaldischargeand 20%at28days.¹¹Hypertension,alcoholism,smoking and dyslipidemiaarecommonestcauseofstrokeamongtheelderly,¹²andsmoking,alcoholism,increasedBMI,diabetesandhypertensionaresignificantlyassociatedwithstrokesamong young people.^13,14 In our study we have seen thatThe majority of the patients were in the age group of >80were 29.55%, followed by 60-70- 25.00%, 50-60were 20.45%, 40-50were 15.91%, 30-40were 9.09%. The majority of the patients were Male i.e. 61.36 and Females were 38.64.The majority of the patients were having Embolic i.e. 34.09%, Thrombotic - 27.27%, Hemorrhagic -20.45%, Cortical venous sinus thrombosis (CVTS)in 18.18% type of the stroke.The majority of the patients complainedof Headachein 94%, Slurredwordsanddifficulty understanding speech in90%, Numbness, weakness or paralysis in face, arm or leg etc.In 80% trouble with seeing in one or both eyes in 60%, Trouble with walkingin 50% of the patients.The majority of the patients associated withAge > 50were 75.00 %,  followed byK/C/O Diabetesin 56.82%, followed byObesity (BMI >30)in 47.73%,K/C/O Hypertensionin 43.18%,H/O Smokingin 38.64%,H/O Alcohol intakein 27.27%, Hyper-lipedemiain 20.45%. These findings are similar to Chirayu V. Vaidya 15 et al they foundcerebrovascular strokes are more common in males (59.7%) than females (40.3%). Most common age group was 61-70 years (32.8%). Most common clinical feature was hemiplegia (72.6%). Most common risk factor was Hypertension (34%) followed by past h/o cerebrovascular stroke (15%), smoking (14%), dyslipidemia (13%). Most common type of stroke was ischemic (74.6%) and hemorrhagic was 2nd (22.9%).

 

CONCLUSION

It can be concluded from our study that majority of the associated factors were Age > 50,  Diabetes, Obesity (BMI >30), Hypertension, Smoking,  Alcohol intake,  Hyperlipedemia.

 

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