Clinico-radiological profile of strokes in Kashmir valley, North-West India: A study from a university hospital

摘要

Background: Globally, ischemic stroke outnumber hemorrhagic strokes. However, it was observed that hemorrhagic stroke is more common in Kashmir valley. The present study was conducted to substantiate this notion, and to identify the possible risk factors. Methods: This prospective study was conducted on 6,906 patients with first ever stroke admitted to S. M. H. S. Hospital, an associated teaching hospital of the Government Medical College, Kashmir, from January 1996 to June 2009. Other than clinical history, examination and routine biochemistry, cranial CT scan (non-contrast) was performed in all the cases within three days of the stroke onset. MRI brain, CSF analysis, screening for cardiovascular disorders, prothrombotic states and collagen profile were performed wherever deemed necessary. Results: There was predilection of stroke among the males and rural population. Eighty three percent of patients developed first-ever stroke in sixth and seventh decade. Fifty four percent of cases had a Glasgow coma score of >10 on admission. Intracerebral hemorrhage was observed in 64.7% patients with male preponderance. Putamen (53.5%) was the most common, site of hemorrhage, followed by thalamus (29.7%). Hypertension, smoking and multiple risk factors were observed in 92.3%, 70.3% and 67.9% cases respectively. Poor antihypertensive medication compliance was observed in 55.9% cases.Conclusions: Intracerebral hemorrhage was the commonest stroke-type observed in Kashmir accounting for close to two third of strokes with male preponderance.