Clinical Profile and Risk Factors of Massive Middle Cerebral Artery Infarction in a Tertiary Care Centre in Central Tamilnadu

ABSTRACT

Introduction: Large territory middle cerebral artery strokesare devastating events that result in high rates of disabilityand death. Nearly half of all stroke survivors never regainfunctional independence. Current research aimed to study theclinical profile and risk factors of massive middle cerebralartery (MCA) infarction and to study the relation of alcoholismand its pattern to massive MCA stroke.Material and methods: Patients admitted with massive MCAinfarct with an early ischemic change on CT affecting at least>50% of the MCA territory within 48 hours of symptom onsetwere included in the study. Stroke mimics and those withhistory of previous stroke were excluded. Study design was across sectional, observational study.Results: A total of 60 cases were analyzed. Mean age was55.4. 35% subjects had NIHSS >20.Diabetes was present in18. Total of 60% were alcoholics, and 83% of males werealcoholics.31 subjects were heavy drinkers. Binge drinkingwas present in 30%.Mean duration of alcohol was 9.5 years.Average intake per day was 120 ml. Mean ASPECT scorein the subjects was 3. 25 patients had a MRS 4 at discharge.Craniotomy done in 6 cases. Total death were 17(29%).Aspiration pneumonia was the common cause of death (5).Conclusion: NIHSS 20 or more was associated with adverseoutcome (P value <0.05).60% were alcoholics. Binge intake in30%(associated with adverse outcome P value <0.05). MeanAspect score was 3 (3 or less associated with adverse outcomeP value <0.05).