ABSTRACT
During past few years identification of many molecules that participate in neuronal death and particularly apoptosis by various experimental studies, has contributed to the information on pathogenesis of ischemic brain injury and oxidative stress has been regarded as one of the mechanisms. The present study has been undertaken to evaluate a free radical, as a measure of lipid peroxidation in patients with cerebral infarction and haemorrhage and also to correlate its level with lesion size and its outcome in the patient. The study included 50 patients of stroke [25 each with infarction and haemorrhage] while 25 comparable subjects served as control. Serum malondialdehyde [SMDA] levels was estimated on the first day of admission in both the study groups as a measure of lipid peroxidation status in these subjects and the lesion size was measured by computed tomography. The mean SMDA level in thrombotic and haemorrhagic group was 4.16 +/- 0.04 nmol/dL and 4.03 +/- 1.1 nmol/dL while it was 1.9 +/- 0.4 nmol/dL in control. The difference in the mean SMDA levels in the controls and study subjects were statistically significant [p<0.001], while the difference between the thrombotic and haemorrhagic groups was statistically insignificant. The mean size of large lesion in thrombotic group was 13.6 +/- 3.0 cm[2] while it was 5.0 +/- 1.4 cm[2] for small lesions. The corresponding values of SMDA with these lesions were 4.98 +/- 0.9 nmol/dL and 3.23 +/- 0.4 nmol/dL. In haemorrhagic group mean size of large lesion was 13.3 +/- 1.9 cm[2] while that of small lesion was 6.6 +/- 1.9 cm[2]. The respective SMDA levels were 5.0 +/- 0.7 nmol/dL and 3.13 +/- 0.2 nmol/dL. There was marked statistical significance [p<0.001] in the SMDA levels between the small and large lesions in both study groups. A significant correlation existed between serum MDA levels, lesion size and early outcome in patients with stroke [p<0.001]. It is, therefore, concluded that the SMDA levels are raised in patients with acute stroke and hence are an indicator of the involvement of lipid peroxidation in its pathophysiology and can also be used as a prognostic markers in subjects with stroke