Abstract

Introduction: Stroke is the third commonest cause of death in India and there is a higher incidence of stroke in young in India than in the developed countries. With an increasing aging population, the stroke burden in India can be expected to reach epidemic proportions. Ischemic stroke accounts for 70-85% of all strokes. The present study was conducted in a tertiary level large neurological centre between 2007-2009 to study the risk factors associated with ischemic stroke and its correlation with angiographic profile. Material & Methods: In this study group of 161 patients, patients were between 15-70 years of age and all cases included were those who presented with first ever ischemic stroke. Patients who had documented cardiovascular causes like RHD, Atrial fibrillation & mechanical heart valves were excluded. Other category who were not included were those with hypercoagulable states like pregnancy, postpartum state and malignancies. Patients were assessed for conventional risk factors for stroke and also procoagulant factors. All patients underwent a DSA of neck and intracranial vessels. The DSA profile was then correlated with their risk factors. Results: Angiographic abnormalities were found in 36% of patients, most of the abnormalities were in extracranial vasculature. Intracranial vascular lesions were seen in 14% of patients which is much higher than western literature where intracranial disease was in 4-6% of cases. Patients were divided in two groups those who had risk factors and angiographic abnormalities vs those who had angiographic abnormalities and no risk factors. Conclusion: There was no significant statistical difference between the two groups who had risk factors and angiographic abnormalities vs those who did not have risk factors and angiographic abnormalities disease, thus risk factors do not predict the likelihood og angiographic abnormality. Other significant conclusion was that stroke in young (17-45yrs) had more procoagulant abnormalities and those in the middle aged and elderly had more of conventional risk factors.