A STUDY ON CLINICO- RADIOLOGICAL PRESENTATION OF STROKE AND ITS ASSOCIATION WITH OUTCOME
Authors: Nag Dr. Arindam , Nag Dr. Sourav , Mondal Dr Suraj , Yadav Dr Yashpal 
Published: June 2019

BACKGROUND:  Cerebrovascular diseases include some of the most common and devastating disorders: ischemic stroke, hemorrhagic stroke, and cerebrovascular anomalies such as intracranial aneurysms and arteriovenous malformations. A stroke, or cerebrovascular accident, is defined by this abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Thus, the definition of stroke is clinical, and laboratory studies including brain imaging are used to support the diagnosis.

AIMS:  1.To correlate clincoradiological findings in terms of prognosis, 2. To know different types of stroke along with its area of involvement and vascular distribution and its relation with outcome, 3. Role of CT SCAN brain as an early diagnostic modality to say clinical outcome.

METHODS: This descriptive epidemiological study with a cross sectional study design is to be conducted in the department of medicine (indoor), R.G.KAR Medical College and Hospital. 1st June 2017 to 31st may 2018. 100 cases to be selected during study period based on following criteria. Detailed clinical history, clinical examinations with Radiological imaging like computed tomography of brain is done. We use scoring system like Intracerebral haemorrhage score, Glasgow coma scale, Modified rankin scale. Based on clinical examination proforma all the study population had been examined including recording of blood pressure and Glasgow coma score at the time of admission. Analysed by Modified Rankin scale till the 5th day post-hospital admission after stroke.

RESULT: Among the total 100 study population 59 cases were of Infarction and 41 cases were of Haemorrhagic type of stroke. Within the 59 Cases of Infarction 39 (i.e. 66%) were male cases and 20 (i.e 34%) were female cases. Within the 41 cases of Haemorrhage 29 (i.e. 71%) were male and 12 (i.e. 29%) were female.  The mean age of the study population of Infarction cases was 55.55 years ±12.84 SD. The mean age of the study population of Haemorrhage cases was 57.48years±13.46SD. Infraction cases show increased mortality among the group having systolic blood & diastolic pressure ≥ 180 mm of Hg, ≥ 110 mm of Hg respectively. Hemorrhagic cases show increased mortality among the group having systolic blood pressure, diastolic pressure ≥ 180 mm of Hg, ≥ 110 mm of Hg respectively.

CONCLUSION: Incidence of haemorrhage is much higher in India (41% as per our study). The study population between 51- 60 years is most predominant age group in both the types of stroke. Most of the infarction cases presents with unconsciousness followed by slurring of speech.  Most common presenting symptoms of Haemorrhagic stroke are unconsciousness, present at about 56% of cases. The most prominent risk factor in our study population is undetected and/or uncontrolled hypertension.  Study population with SBP ≥180 and/or DBP ≥110 mm of Hg group have increased rate of mortality from stroke. The major type of ischemic stroke in our study population is partial anterior circulation stroke (PACI) 47.4%. Most of the study population having  Infarction has developed severe disability at the end of 5 days of observation, comprising of 40.5% of the total observation.

Keywords:  CVA (cerebrovascular accident), CT Scan (computed tomography), MRI (Magnetic resonance imaging), GCS Scale (Glasgow coma scale)