Predictors pf ischemic versus hemorrhagic strokes in hypertensive patients

To identify the factors that predispose to ischemic versus hemorrhagic stroke in hypertensive patients. Cohort study. The study was conducted at the Aga Khan University Hospital [AKUH], Karachi, from August 1999 to May 2001. All the hypertensive patients, who were registered in AKUH acute stroke outcome data base, over a period of 22 months, were identified and from this cohort the patients with first ever stroke were selected. The data regarding demographics, stroke type [ischemic vs. hemorrhagic], pre-existing medical problems, laboratory and radiological investigations was recorded and analyzed. Five hundred and nineteen patients with either ischemic stroke or parenchymal hemorrhage were registered over a period of 22 months. Three hundred and forty-eight patients [67%] had hypertension and of these, 250 had first ever stroke at the time of admission. Presence of diabetes mellitus [OR: 3.76; CI: 1.67-8.46] and ischemic heart disease [OR: 6.97; CI: 1.57-30.98] were found to be independent predictors of ischemic strokes. Presence of diabetes mellitus and ischemic heart disease predict ischemic stroke in a patient with hypertension

Prognostic factors in ganglionic and thalamic haemorrhages: a clinical and radiological study

Clinical and radiological features of 43 patients admitted for ganglionic [21] and thalamic [22] haemorrhages were studied to ascertain the factors that would determine prognosis in the acute stage of the illness. Nineteen patients died, 16 of them in the first week. The adverse clinical factors were an altered state of consciousness, decorticate/decerebrate posturing, ataxic respiration, abnormalities of gaze and presence of bilateral Babinski's sign. Adverse radiological factors were the presence of thalamic haemorrhage of 3 cm or more, intraventricular spread of the haemorrhage and midline shift of 0.5 cm of more. The significance of these findings is discussed