ABSTRACT
Objective: To evaluate correlation of Alberta Stroke Program Early CT Score (ASPECTS) and early and delay outcome measures among acute anterior ischemic stroke patients who presented within 48 hours of stroke onset. Methods: In a prospective cohort study, we recruited consecutive patients with acute middle cerebral artery (MCA) ischemic stroke who presented within 48 hours of stroke onset. All the patients were evaluated at admission (Glasgow Coma Scale - GCS and National Institute of Health Stroke Scale - NIHSS) at discharge (GCS, NIHSS, Barthel Index - BI and modifi ed Rankin Scale - mRS) and at 3 months (BI and mRS). CT ASPECTS was calculated by two observers independently. We divided patients in to two groups with ‘Better’ and ‘Worse’ ASPECTS with score of 8-10 and 0-7 respectively and compared the primary and secondary stroke outcome measures. Results: Among 100 patients with acute MCA infarction (median age 55 yrs, 62 males), median ASPECTS scores had inter-rater reliability of 0.82. The mortality, GCS and NIHSS at discharge, and mRS and BI at 3 months are signifi cantly better among patients with ‘Better’ compared to ‘Worse’ APSECTS. The hospital stay was shorter in patients with Better ASPCTS. Conclusion: In the setting of acute ischemic stroke, ASPECTS has good correlation with severity of stroke, and is strong predictor of early and delayed outcome in acute ischemic stroke.
ABSTRACT
Mononeuropathy multiplex is a rare disorder associated with idiopathic thrombocytopenic purpura. Extrinsic compression due to hematoma, intraneural bleed and immune mediated nerve injury are reported mechanisms of neuropathy. We report of a case of a girl with recurrent idiopathic thrombocytopenic purpura with mononeuropathy multiplex, along with a brief review of the mechanism of neuropathies in asscociation with idiopathic thrombocytopenic purpura.
ABSTRACT
Bilateral facial palsy is a relatively uncommon condition and its early identification after head injury can be particularly challenging. It is often not realized that it can be also extremely debilitating in terms of psychosocial functioning. We report a 35-year-old male who fell down while trying to alight from a moving train and lost consciousness for 30 minutes. It was later during the course of his hospitalization for observation that his bilateral facial palsy was recognized. Due to poor feeding because of compromised oral function and inability in expressing emotions, he had significant impairment of psychosocial functioning. He was particularly concerned about his complete inability to smile and as a result, was reluctant to go back to work and socialize with friends