Stroke in Young; A study on clinical profile and diverse presentation in a tertiary care hospital

Lt Col (Dr) Dheeraj Kumar; Lt Col (Dr) Sanjay Kumar Sharma; Lt Col (Dr)  Rajendra Pal Singh; Lt Col (Dr) Dronacharya Routh; Lt Col (Dr) Binu Shekhar; Maj Gen (Dr) AK Hooda; Col (Dr) Balbir Singh Deswal

Volume : VII, Issue : I, January - 2018

Stroke in Young; A study on clinical profile and diverse presentation in a tertiary care hospital

Lt Col Dr Dheeraj Kumar, Lt Col Dr Sanjay Kumar Sharma, Lt Col Dr Rajendra Pal Singh, Lt Col Dr Dronacharya Routh, Lt Col Dr Binu Shekhar, Maj Gen Dr Ak Hooda, Col Dr Balbir Singh Deswal

Abstract :

BACKGROUND: Stroke in a young person can be devastating as the patients are at their most productive age, thus causing marked long term socio–economic consequences and high public health impact due to associated indirect costs. In this study, all young patients of stroke meeting the criteria reporting to a tertiary care hospital in a metropolitan city were studied for various clinical presentations and outcome under standard protocol to combat deadly disease.

OBJECTIVE: To study the various clinical presentations in patients of stroke in age group 15–49 years.

MATERIALS AND METHODS: A Prospective observational study was conducted on 144 patients presented to a tertiary care hospital during study period studying the clinical presentations, management and outcome. Data were analysed using Statistical Programme for Social Sciences (SPSS).

RESULTS: Incidence of ischemic strokes was 68.7%, while 13.2% patients were of haemorrhagic strokes and 18.1% patients were of cereal venous thrombosis (CVT). As per TOAST criteria for ischemic stroke subtypes, 47.5% were large artery strokes, 27.3% were small artery strokes and 3.0% were cardio–embolic strokes. Among haemorrhagic strokes lobar bleeds were most common (47.1%). Mean age of patients was least in CVT and most in haemorrhagic strokes. The most common presentation in Ischemic and haemorrhagic strokes was hemiplegia while CVT presented as headache in 92.3% cases. The mean systolic and diastolic blood pressures were higher in case of haemorrhagic as compared to ischemic strokes. At presentation Mean NIHSS for Ischemic strokes was 7.09 & mRS score2.67; which was 2.61 (minimum 0, maximum 9) and 1.13(minimum 0, maximum 4) respectively at review. In haemorrhagic strokes – at presentation mean NIHSS was 8.74 & mRS score 3.58; while at review 3.18 and 1.24 respectively. Mean NIHSS in CVT at presentation was 3.64 & mRS score 2.27; at review 0.29.CONCLUSION: Ischemic strokes had highest incidence as compared to haemorrhagic strokes and CVT. However, CVT was more prevalent in younger age group. Majority of the patients had good functional recovery at review. CVT had the best functional outcome. Stroke in young still needs to be studied in detail to combat this deadly and disabling disease.