A Study on Clinical Profile and Etiological Factors of Cerebrovascular Disease in Young Patients

Abstract

Aim& Objectives: To study clinical profile and etiological factors of cerebrovascular disease in young patients. Methodology: Stroke is a common disease manifestation in our clinical practice. In hospital cerebro vascular disease manifesting in young is not uncommon, hence we studied various etiological factors contributing stroke under the age of 45 years. 100 patients between 15 - 45 years of age were admitted in tertiary care teaching Hospital. A total of 100 consecutive patients diagnosed with stroke satisfying the inclusion criteria. Results: The sex ratio in our study was1.3:1.the majority of stroke occurred between the ages of 36-40 years at 24%.in males highest incidence were seen in the same age group. where as in females it was in the ages between 21-25years at 28.6%.14% of the study population presented with seizure. decreased consciousness was seen in 60% of the group.34% of the patients had speech abnormalities. The most common cranial nerve affected was the facial nerve at 56%.motor deficit seen in all the patients. Hemisensory loss was seen in14% of the study group. only 2%of the patient had cerebellar deficit. 36% of all the patient were smokers, among these 35.9% were ischemic and 36.4% were hemorrhagic stroke. Alcohol consumption was seen in 30% of patients. Among these 28.2% were ischemic and 36.4% were hemorrhagic stroke. 12% of the study group was overweight. Among ischemic strokes were 15.4% where as none of the cases of hemorrhagic stroke were overweight. Diabetes mellitus was seen in 24% of the patients.28.2% of diabetics had ischemic stroke and 9.1% had hemorrhagic stroke. Hypertension and CAD were seen in 32%and 18% of the total number of patients respectively. Among ischemic strokes 15.4% were Hypertensive ,20.5% had CAD, where as Hypertension and CAD were seen 90.9% and 9.1%of hemorrhagic strokes respectively. Transient ischemic stroke and Family history of stroke were both seen in 2% of the patients.2.6% of ischemic strokes had this history. None of hemorrhagic stroke had this previous history. 4% of the patients were taking OC pills. Among these 2.6%and 9.1% were ischemic and hemorrhagic strokes respectively. Elevated Homocystein levels were seen in12% of patients 15.4% had ischemic strokes and none of the hemorrhagic strokes had hyper homocysteinemia. LDL and HDL were abnormal in 60% and 72% of the patients respectively. Ischemic stroke had abnormal LDL and HDL 61.5% and 74.4% of the patients respectively. Among hemorrhagic stroke LDL and HDL was seen to be abnormal in 54.5%and 63.6% of patients respectively. Atherosclerosis was seen in 32% of patents. Cortical Venous thrombosis was seen in 18% of patients, all them were women. Tubercular Meningitis, RHD, SLE were seen 12%,10%,4% of patients respectively. Out of 100 cases of stroke in young, 78% of the strokes were ischemic where as 22% of them had hemorrhage. Conclusion: Hypertension and Diabetes mellitus were non modifiable risk factors commonly seen. especially hypertension in cases of Intra cerebral hemorrhage. Rare risk factor like Homocystein should be considered during evaluation. Lipid abnormalities such as elevated LDL and decreased HDL were also common. Atherosclerosis was the most common etiology for stroke in young. Cortical Venous Thrombosis should be kept in mind in females.