Introduction: The burden of stroke is increasing worldwide; stroke is now the fourth leading cause of death and the fifth leading cause of disability amongst all age groups. The incidence and mortality of stroke is higher in Asian countries than Western countries. Crude incidence of stroke ranged from 108 to 172/100,000 people per year, crude prevalence from 26 to 757/100,000 people per year, and one-month case fatality rates from 18% to 42%. Anterior circulation stroke is the commonest type whereas the posterior circulation stroke comprises only 20% of the stroke. Therefore, it is important to determine the clinical profile among stroke patients.

Aim:

1. To study clinical profile among ischemic and haemorrhagic stroke.
2. To study the risk factor prevalence in ischemic and haemorrhagic stroke in adults.

Methods: This hospital - based cross sectional study was conducted over six months in the department of General medicine in a tertiary care hospital in Puducherry. After the initial assessment, all the patients were subjected to a general physical examination followed by a laboratory and radiological investigations following which ABPI, NIHSS and mRS were calculated and patients will be assessed for risk factors, clinico-radiological features of stroke.

Results: A total of 63 patients were participated in this study. The overall result shows significant differences in clinical profile and risk factors among different types of strokes.

Conclusion: This study was helpful in identifying the risk factors, clinico-radiological features among Ischemic, Hemorrhagic, Anterior and posterior circulation stroke.

Keywords: Anterior circulatory stroke, Posterior circulatory stroke, Ischemic stroke, Hemorrhagic stroke, NIHSS- National Institutes of Health Stroke Scale, mRS - Modified Rankin Scale, ABPI – Ankle brachial pressure index.   

1. Vaidya CV, Majmudar DK. A retrospective study of clinical profile of stroke patients from GMERS Medical College and Hospital, Gandhinagar, Gujarat. Int J Clin Trials. 2014 Jul;1(2):62-6.
2. Kannan V, Justin C, Prashanth PRS, Alexander N. Clinical prevalence of stroke in a tertiary care hospital in Southern India. Int J Res Med Sci. 2021 Mar;9(3): 838-841
3. Kumar M, Kumar A, Saroj U, Kumar R, Singh SK, Choudhary AK, et al. A Study on the Clinical Profiles of Patients With Cerebrovascular Accident (Stroke) in a Tertiary Care Hospital in Jharkhand. Cureus. 2023 Mar 9;15(3):35919.
4. Pollack A, Harrison C, Henderson J, Miller G: Stroke. Aust Fam Physician. 2014, 43:93
5. Kaur G, Samar N, Sharma J, et al. A Study of Clinico-radiological and Socio-demographic Profile of Patients with Stroke in a Terttary Care Hospital of South West Rajasthan. The Journal of the Association of Physicians of India. 2020 Mar;68(3):54-58.
6. Aiyar I. A study of clinic-radiological correlation in cerebrovascular stroke (a study of 50 cases). Guj Med J. 1999;52:58-63.
7. Kim JS, Nah HW, Park SM, et al.: Risk factors and stroke mechanisms in atherosclerotic stroke: intracranial compared with extracranial and anterior compared with posterior circulation disease. Stroke. 2012, 43:3313-8. 1161/STROKEAHA.112.658500.
8. Merkler, A. E., Parikh, N. S., Mir, S., Gupta, A., Kamel, H., Lin, E., Lantos, J., Schenck, E. J., Goyal, P., Bruce, S. S., Lansdale, K. N., LeMoult, J., Jayaraman, M., Yaghi, S., & Navi, B. B. (2020). Risk of Ischemic Stroke in Patients With COVID-19 Versus Patients With Influenza. JAMA Neurology, 77(11), 1366–1372.
9. Tribelhorn S, Motara F, Lewis CM. Stroke: A retrospective review of the incidence and epidemiology in a South African academic hospital emergency department. South African Medical Journal = Suid-afrikaanse Tydskrif vir Geneeskunde. 2021 Dec;111(12):1205-1210. DOI: 10.7196/samj. 2021.v111i12.
10. Frid P, Drake M, Giese AK, Wasselius J, Schirmer MD, Donahue KL, Cloonan L, Irie R, Bouts MJ, McIntosh EC, Mocking SJ. Detailed phenotyping of posterior vs. anterior circulation ischemic stroke: a multi-center MRI study. Journal of neurology. 2020 Mar;267:649-58.
11. Wang, X., Huang, Y., Chen, Y. et al. The relationship between body mass index and stroke: a systemic review and meta-analysis. J Neurol 269, 6279–6289 (2022).
12. Shahi MS, Rahman A, Wadud MS, Saha UK, Ahmed ATU, Ali Z, et al. Association of Ankle Brachial Pressure Index (ABPI) in Patients with Ischemic Stroke: A Case Control Study. Chatt Maa Shi Hosp Med Coll J 2013 Oct. 28; 12(3):27-33.
13. Li, Bingxian MD; Liu, Shuo MD; Liu, Xiaoqiang MD; Fang, Jingnian MD; Zhuang, Weiduan BS. Association between red cell distribution width level and risk of stroke: A systematic review and meta-analysis of prospective studies. Medicine 99(16):p e19691, April 2020.
14. Smyth A, O'Donnell M, Rangarajan S, Hankey GJ, Oveisgharan S, Canavan M, McDermott C, Xavier D, Zhang H, Damasceno A, Avezum A, Pogosova N, Oguz A, Ryglewicz D, Iversen HK, Lanas F, Rosengren A, Yusuf S, Langhorne P; INTERSTROKE Investigators. Alcohol Intake as a Risk Factor for Acute Stroke: The INTERSTROKE Study. Neurology. 2023 Jan 10;100(2):e142-e153.

Dr Ezhil Kumaar M

Post Graduate Resident, Department of Internal Medicine, Sri Manakula Vinayagar Medical College and Hospital – Puducherry