Hospital based epidemiological study of cerebrovascular stroke

Epidemiological studies are essential in order to assess the extent of cerebrovascular disease, its natural cause, major differences between countries, etiological and prognostic factors, and for planning therapeutic trials [Beech et al., 1996]. The present study aimed at evaluating some epidemiological aspects of recent cerebrovascular stroke, evaluating the benefits obtained from different neuroimaging tools such as magnetic resonance imaging [MRI], computerized tomography [CT] and transcranial Doppler ultrasonography [TCD] and evaluating some risk factors of stroke such as age, sex and other demographic characteristics, smoking, hypertension, diabetes, hyperlipidaemia and some hematological, cardiac, and blood chemistry variables. The present study included 235 patients with cerebrovascular stroke admitted to stroke unit in Ain Shams University Specialized Hospital, 173[73.6 percent] patients with cerebral infarction, 26 [11.1 percent] patients with cerebral hemorrhage, 13 [5.5 percent] patients with hemorrhagic infarction, and 23 [9.8 percent] patients with lacunar infarction. The mean age of the total sample of the patients included in our study was [61.75 +/- 11.59], it ranged from 25 to 90 years. We found that there is difference in sex distribution as males [n=161] represent 68.5 percent of patients while females [n=74] represent 31.5 percent, among our male patients III [68.9 percent] were smokers while 50 [32.1 percent] non-smokers and all of our female patients were non-smokers, at the same time, 181 of the patients [77 percent] were hypertensive while 54 of them [23 percent] were non-hypertensive, also, 116 patients [49.4 percent] were diabetic while 119 [50.6 percent] were non-diabetic, and the mean of non-fasting glucose level in cerebral infarction [l92 +/- I07.9mg/dl] was higher than in patients with cerebral hemorrhage [186 +/- 120.5]. Regarding other laboratory parameters we found that mean of total cholesterol in patients with cerebral infarction [207.3mg/dl] was approaching significantly higher [p=0.056] than in patients with cerebral hemorrhage [185.7mg/dl], also, triglyceride level was significantly higher [p=0.03] in patients with cerebral infarction [I48.6mg/dl] than in patients with cerebral hemorrhage [113mg/dl], at the same time, the mean of total leukocytic count was non-significantly higher [p=0.90] in patients with hemorrhagic cerebral infarction [12. l +/- 4.65x10[3]cell/cmm] than in patients with lacunar infarction [10.0565xl0 [3]cell/cmm] than patients with cerebral hemorrhage 9.9565x10[3]cell/cmm], although, the mean of ESR in the total stroke patients was [36.41 +/- 23.48], it was higher in patients with all subtypes of cerebral infarction. Our study confirmed the significance of heart disease as a risk factor for stroke, particularly for ischemic stroke, and hemodynamically significant carotid artery stenosis [>70 percent] was detected in 15 [6.4 percent] patients, of them 14 patients with cerebral infarction while only one patient with cerebral hemorrhage. In our study TCD was done to 133 patients 10 with cerebral hemorrhage and 123 with cerebral infarction, intracranial stenosis was detected in 76 [61.7 percent] patients from those with cerebral infarction, and 3 [30 percent] patients from those with cerebral hemorrhage, and there is statistically significant difference [p=0.013] between ischemic stroke subtypes as intracerebral stenosis was detected in 67 percent of patients with cerebral infarction while only in 30 percent of patients with lacunar infarction The present study included 235 patients with cerebrovascular stroke. The mean age [ +/- SD] of the total sample of the patients included in our study was [61.75 +/- 11.59], it ranged from 25 to 90 years, it included 161 [68.5 percent] males, and 74 [31.5 percent] females. The most common risk factors detected in our stroke patients were, increasing age, smoking, hypertension, diabetes, hyperlipidemia, cardiac diseases, carotid artery stenosis, as well as intracranial arterial stenosis

Study of brainstem auditory evoked response in asphyxiated neonates

The present study was undertaken to evaluate the effect of neonatal asphyxia on brainstem auditory evoked response [B A E R] and the possible reversibility of abnormal BAER on follow up after 3 months of age. Prospective case control study was done in the neonatal special care unit and neurology department, at EL-Minia university hospital. Twenty five term neonates with 5-minute Apgar score< 6, who had hypoxic ischemic encephalopathy [HIE] or asphyxia underwent BAER testing with follow up at 3 months. Twenty age and sex-matched normal neonates served as control. Denever development screening test [Denever II] was performed at 3 months of age. Twelve out of twenty five [48 percent] neonates with birth asphyxia showed abnormalities on initial BAER. The commonest abnormalities seen were raised threshold of interside latency difference in 8/12 neonates [66.7 percent], followed by prolongation of latencies of various waves in 6/12 neonates [50 percent]. Other abnormalities observed were prolonged intervene interval [16.7 percent] and prolonged interside interval difference [8.3 percent]. There were a significant association of BAER abnormalities with duration of neurological findings more than 5 days and stages of HIE. On follow up of 12 cases at 3 months of age, abnormalities in BAER reverted back to normal in 11 cases [91.6 percent]. The Denever Developmental screening test [Denever II] was suspect in 3 cases only. It was concluded that BAER abnormalities in neonatal asphyxia are transient and revert back to normal in most cases on follow up at 3 months of age and BAER is simple non invasive tool but does not appear to be a useful one for early detection of neurological handicaps