A study performed on 122 patients diagnosed with ischemic cerebrovascular stroke presented to the Emergency department of Alexandria University hospital during the period from 1/7/2014 to 31/12/2014 in order to study the prevalence of disturbed level of consciousness in this group of patients. Those patients were subjected to history taking, clinical examination, and assessment of the LOC, laboratory investigations and radiological examination using CT-brain and MRI in selected cases.

The most common risk factors were hypertension then Diabetes Mellitus. Males were more affected than female and the mean age of the patients was 59 years and the mean systolic blood pressures of patients were 144 mm.Hg.

Based on the GCS it was found that 27% of the patients had DLC. The patients were classified according to the severity of the impairment of the LOC into mild (GCS 14-13), Moderate (GCS 12-9) and Severe (GCS 3-8).Mild cases comprised 36.3% , moderate 33.3% and severe 30.3% of DLC patients.33.3% of the DLC patients were intubated.

The most important CT-brain finding in the DLC patients was MCA infarction that was found in 45.5% of DLC patients. Those patients are more labile to develop brain swelling and haemorrhagic transformation. It was found that 40% of MCA stroke patients were in deep coma.

Infratentorial infarctions also are an important causes for the occurrence of disturbed level of consciousness.

Hypertension is an important risk factor for stroke yet, it was found no significant correlation between hypertension and DLC.

It was found that there was a significant correlation between DLC and the admission hyperglycaemia and hyponatremia. While there was no correlation between raised admission Creatinine level and altered mental status.

Keywords: Disturbed level of consciousness , Cerebrovascular stroke , GCS.

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Mohamed Elsayed Mohamed

Emergency Department, Faculty of Medicine University of Alexandria, Egypt