DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20161200

Detailed epidemiological analysis of cerebrovascular disease, the first study from Eastern India

Sudeb Mukherjee, Pritam Chatterjee, Kaushik Manna, Suhana Datta

Abstract


Background: Prevalence of cerebrovascular diseases (CVD) is rising in India along with its morbid impact. Till now there is no study from Eastern India to reflect the current scenario of cerebrovascular diseases in this part of world. This study destined to know and analyse several epidemiologic factors behind cerebrovascular diseases in Eastern India.

Methods: 108 patients who were admitted with symptoms of stroke were analysed based on several parameters. They were investigated, treated and their outcomes were followed.

Results: Correlation between clinical findings and radiological confirmation was much more in case of infarction (65%) compared to haemorrhagic cases (22%). Superior division of the middle cerebral artery was the commonest site get involved in infarction cases and internal capsule area is the most commonly involved area in lacunar infarction almost one third of haemorrhagic patients had intraventricular extension. Most common association with this was thalamic bleeding although most common site of haemorrhage was lentiform nucleus. Among the patients with hemorrhage with intraventricular extension 50% were thalamic bleed and 50% were non thalamic bleed (mainly lentiform nucleus). In hospital mortality rate was found to be highest in non-thalamic group (63%). Overall mortality in non-thalamic bleed was higher though not statistically significant.

Conclusions: Haemorrhagic CVD is much more prevalent in this part of world compared to western population. Clinico radiologic correlation is much more in ischaemic infarction hypertension and smoking are two strong associations in cerebrovascular diseases.

 


Keywords


CVD, Hypertension, MRI, CT scan

Full Text:

PDF

References


Longo DL, Kasper DL, Jameson JL, Fauci AS, Hauser SL, Loscalzo J. Harrison principles of internal medicine. 18 th edition. pg-3270.

Zhuang L, Wen W, Zhu W, Trollor J, Kochan N, Crawford J, et al. White matter integrity in mild cognitive impairment: a tract -based spatial statistics study. Neuroimage. 2010;53:16-25.

Yamaguchi Y, Wada M, Sato H, Nagasawa H, Koyama S, Takahashi Y, et al. Impact of ambulatory blood pressure variability on cerebral small vessel disease progression and cognitive declinein community-based elderly Japanese. Am J Hypertens. 2014;27(10):1257-67.

Wen HM, Mok VC, Fan YH, Lam WW, Tang WK, Wong A, et al. Effect of white matter changes on cognitive impairment in patients with lacunar infarcts. Stroke. 2004;35:1826-30.

Vogt G, Laage R, Shuaib A, Schneider A. Initial lesion volume is an independent predictor of clinical stroke outcome at day 90: an analysis of the Virtual International Stroke Trials Archive (VISTA) database. Stroke. 2012;43(5):1266-72.

Taylor WD, Bae JN, MacFall JR, Payne ME, Provenzale JM, Steffens DC, et al. Widespread effects of hyperintense lesions on cerebral white matter structure. Am J Roentgenol. 2007;188:1695- 704.

Bamford J, Sandercock P, Dennis M, Burn J, Warlow C.l, Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991;337:1521-6.

Naik M, Rauniyar RK, Sharma UK, Dwivedi S, Karki DB, Samuel JR. Clinico-radiological profile of stroke in eastern Nepal: A computed tomographic study. Kathmandu University Medical Journal. 2006;4:161-6.

Kochar DK, Joshi A, Agarwal N, Aseri S, Sharma BV, Agarwal TD. Poor diagnostic accuracy and applicability of Siriraj stroke score, Allen score and their combination in differentiating acute hemorrhagic and thrombotic stroke. J Assoc Physicians India. 2000;48(6):584-8.

Hawkins GC, Bonita R, Broad JB, Anderson NE. Inadequacy of Clinical scoring systems to differentiate stroke subtypes in population-based studies. Stroke. 1995;26:1338-42.

Wouter JS, Stanley T, Michael BS, Scott WA. Diffusion-weighted MRI in acute lacunar syndromes -a clinical-radiological correlation study. Stroke. 1999;30:2066-9.

Kumar S, Selim, MH, Caplan LR. Medical complications after stroke. Lancet Neurol. 2010;9:105-18.

Qureshi AI, Suri F, Kirmani J, Kirmani JF, Divani AA.. Prevalence and trends of prehypertension and hypertension in United States: National Health and Nutrition Examination Surveys 1976 to 2000. Med Sci Monit. 2005;11:CR403-9.

Thrift AG, Donnan GA, McNeil JJ. Reduced risk of intracerebral hemorrhage with dynamic recreational exercise but not with heavy work activity. Stroke. 2002;33(2):559-64.

Shaper AG, Phillips AN, Pocock SJ, Walker M, Macfarlane PW. Risk factor for stroke in middle aged British men: BMJ. 1991;302:1111-5.

Keli S, Bloemberg B, Kromhout D. Predictive value of repeated systolic blood pressure measurement for stroke risk, The Zutphen study. Stroke. 1992;23:347-51.

Sagie A, Larson MG, Levy D. The natural history of borderline systolic hypertension. N Eng J Med. 1993;329:1912-7.

Petrovich H, Curb D, Bloom ME. Isolated systolic hypertension and risk of stroke in Japanese- American men. Stroke. 1995;26:25-9.

Thrift AG, Mcneil JJ, Donnan GA. The risk of intracerebral haemorrhage with smoking. The melbourne risk factor study group. Cerebrovasc Dis. 1999;9(1):34-9.

Kurth T, Kase CS, Berger K, Schaeffner ES, Buring JE, Gaziano JM. Smoking and the risk of hemorrhagic stroke in men. Stroke. 2003;34(5):1151-5.

Bhat VM, Cole JW, Sorkin JD, Wozniak MA, Malarcher AM, Giles WH, et al. Dose-response relationship between cigarette smoking and risk of ischemic stroke in young women. Stroke. 2008.;39(9):2439-43.

Ockene IS, Miller NH. Cigarette smoking, cardiovascular disease, and stroke for the American heart association task force on risk reduction. Circulation. 1997;96:3243-7.

Ralph LS, Mitchell E, Bernadette BA, Lin IF, Douglas EK, Hauser WA, et al. The protective effect of moderate alcohol consumption on ischemic stroke. JAMA. 1999;281:53-60.

Meir JS, Graham AC, Walter CW, Frank ES, Charles HH. A Prospective Study of Moderate Alcohol Consumption and the Risk of Coronary Disease and Stroke in Women. N Engl J Med. 1988;319:267-73.

Kristi R, Brian L, John D, Nolen L, Gregory LK, Jiang H, et al. Alcohol consumption and risk of stroke -a meta-analysis. JAMA. 2003;289:579-88.

Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C. Epileptic seizures after a first stroke: the Oxfordshire community stroke project. BMJ. 1997;315:1582-7.

Muir KW, Grosset DG. Neuroprotection for acute stroke: making clinical trials work. Stroke. 1999;30(1):180-2.

Sudlow CL, Warlow CP. Comparing stroke incidence worldwide; what makes studies comparable? Stroke. 1996;27(3):550-8.