Volume : IX, Issue : VI, June - 2019

Neuroimaging in young stroke: A Hospital based study

Pratik Chakraborty, Binod Sarmah, R K Gogoi

Abstract :

Stroke is one of the most important public health problems with a global socio–economic impact and a major cause of disabilities. Stroke in young is a rare but catastrophic event. Stroke in young requires a different approach to investigate and treat. This is due to the different underlying etiology as compared to elders. Methods: This hospital based cross sectional study was carried out in Assam Medical College & Hospital, a tertiary care hospital in Upper Assam to diagnose and categorize stroke in young (aged 15–45years) patients with CT or MRI and to find out the risk factors and etiology for young stroke with the help of clinico–biochemical parameters and imaging study. Results: A total of 50 young stroke cases (23 male and 27 female) were studied during the study period. Mean age of the cases was 34.2 ±9.02 years with maximum numbers of cases in the age group of 15–25 years. Ischemic stroke accounted for 46 % followed by intracereal hemorrhage (36 %), venous stroke (8%), spontaneous subarachnoid hemorrhage (6%) and mixed stroke (4%). Risk factors were detected in 74 % of the cases and hypertension was the most common risk factor found in 24 % cases. Most common site of ischemic stroke was in the MCA territory (43%) and multiterritorial infarcts were seen in 21.7 % of cases. Echocardiography was abnormal in 36% cases of ischemic stroke and rheumatic heart disease was the most common echocardiographic abnormality detected in the study. On ASCOD phenotyping, cardiogenic stroke was the most frequent etiologic subtype accounting for 39.1 % of all ischemic stroke cases. Atherosclerosis was found in 30.4 % of all cases of ischemic stroke followed by small vessel disease (8.7 %) and other causes (17.4 %). In our study, arterial dissection was seen in one (4.3 %) patient with ischemic stroke. Study showed, casual link between the etiologic phenotype & stroke was found in 52.2 % of the cases of ischemic stroke and causal link was uncertain in 26.1 % of the cases. In 17.4 % of the cases, causal link between the etiologic phenotype was unlikely. Eighteen (36%) cases were having intracereal bleeding and 6% had Spontaneous subarachnoid hemorrhage. Basalganglia was the commonest location for a hemorrhagic stroke (44.4 %) followed by lobar bleed (28 %), primary intraventricular hemorrhage (16.7 %) and ainstem hemorrhage (5.1%).Various risk factors detected in the intracereal hemorrhage were hypertension(22.2%) vascularanomalies(50%) pregnancy/puerperium 2(11.1 %), vasculitis 2(11.1%), obesity 1(5.6%), smoking 1(5.6 %) and undetermined in 16.7 % cases. Spontaneous subarachnoid hemorrhages were seen in 3 cases and an underlying aneurysm was identified in all the cases. In this study, 4 (3 male and 1 female) cases of venous stroke were encountered out of which there were 2 cases of combined dural venous sinus and cortical vein thrombosis and 1 case each of superior sagittal sinus and transverse/sigmoid sinus thrombosis. Conclusion: Modifiable risk factors are common in young stroke patients. Brain imaging findings differ in young patients compared to that seen in middle–aged and elderly population, possibly because of the different etiologic spectrum

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

NEUROIMAGING IN YOUNG STROKE: A HOSPITAL BASED STUDY, Pratik Chakraborty, Binod Sarmah, R K Gogoi INDIAN JOURNAL OF APPLIED RESEARCH : Volume-9 | Issue-6 | June-2019

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