RESUMO
Introduction: Stroke is defined as rapid onset of focal neurological deficit resulting from diseases of cerebral vasculature and its contents. Community surveys in India have shown a crude prevalence rate for hemiplegia in the range of 200 per 100,000 persons, nearly 1.5% of all urban hospital admission, 4.5% of all medical and around 20% of neurological cases. The aim of the study: To determine the usefulness of doing Carotid Doppler Ultrasonography as a screening procedure in predicting the chance of developing stroke in persons having risk factors for stroke. Materials and methods: The study was conducted in Department of Medicine, Government Dharmapuri Medical College, Dharmapuri in December 2017 to January 2018. In this study, patients who were admitted with a history of sudden onset of neurological illness are subjected to CT scan brain. Among the patients who had suffered an ischemic stroke in the anterior circulation are selected and they were further evaluated. Results: Hypertension was present equally in 58% of the males and females studied. Hence this study confirmed that hypertension is one of the major risk factors for the development of stroke and control of hypertension will reduce the risk of developing stroke. In this study diabetes as a risk factor was present in 89% of females and 41% of males. Hence this study observed that patients with diabetes are at increased risk for all forms of ischemic stroke and also are more likely to have hypertension and hyperlipidemia. Information from other studies also suggests that higher total and low-density lipoprotein (LDL) cholesterol levels are associated with an increased risk of ischemic stroke. Conclusion: Carotid Doppler Ultrasonography cannot substitute for angiography as the sole preoperative tests for Carotid endarterectomy. However, it can be used as a screening test for the detection of the asymptomatic Carotid disease in patients with risk factors for stroke.
RESUMO
Introduction: Migraine is a syndrome of recurrent headaches which commonly affects the most productive age group. The clinical presentation of a migraine varies is from the patient. The drug treatment needs to be selected by grouping into different categories based on the clinical profile. In this study, an attempt has been made to study the clinical spectrum EEG changes and therapeutic response in patients with a migraine. Aim of the study: To study the clinical spectrum of a migraine, to study the EEG changes in migraine patient, to assess the therapeutic response in patients treated with prophylactic drugs. Materials and methods: In this study, patient with age between 12 years and 60 years who attended the headache clinic and satisfied the international headache society criteria for a migraine included the patients were evaluated in the following way: Detailed History taking, Physical examinations, laboratory investigations. Results: In the present study, most of the patients were in the age group of 30 to 35 years in both migraine with aura (MA) and migraine without aura (MO) (MA 48% and MO 52%). The minimum age in this study was 14 years maximum age was 54 and the mean age was 33.2. Prevalence of a migraine varies with age peaking between age of 30 to 45 years. Overall prevalence was highest from 25 to 55 years of being productive age. The family history of a migraine was present in 32% of the total patients (MA 62% to 32%) seen predominantly in first degree relatives. The present rating factors were found in 76% of patients in the study group. Stress was commonest precipitating factor for migraine (MA 33%, MO 50%). Other precipitating factors were menses (MA 17%, MO 20%) hunger (MA 17%, MO 15%), sleep deprivation (MA17%, MO15%), food (MA 5%), head trauma (MA11%). In this study group, 61 patients had followed up for more than 3 months. Among them, 26 patients 42.6% were treated with three propranolol 33 patients 54% were treated which combination J. A. Vasanthakumar, K. Ganesamoorthi. A study on migraine in tertiary care centre at Dharmapuri IAIM, 2018; 5(3): 8-14. Page 9 of Beta blocker and amitriptyline and 2 patients 3.2%were treated with sodium valproate. At the end of 3 months, response to therapy was assessed by MIDAS score. Conclusion: Prodrome symptoms were present in 38% of patients and postdrome symptoms were present 50% of the patients. Visual Aura was the commonest aura. A headache was predominantly unilateral 72% pulsatile 95% moderate-to-severe intensity of pain 83% with the main duration of 16.5 hours. Nausea and vomiting were commonest associated symptoms. Stress was a commonest precipitating factor.