22. European Stroke Conference 316 Etiology of stroke and risk factors Ischemic stroke was more severe and immune response impairment was more pronounced in the patients with coexisting causes E.K. Sidorovich1, S.A. Lichachev2, T.V. Amvrosieva3, Z.F. Bogush4, N.V. Goncharova5, U.S. Shabalina6 Republican Research and Practical Centre of Neurology and Neurosurgery, Minsk, BELAR-US1, Republican Research and Practical Centre of Neurology and Neurosurgery, Minsk, BELAR-US2, Epidemiology and Microbiology Research Center, Minsk, BELARUS3, Epidemiology and Microbiology Research Center, Minsk, BELARUS4, The Belarus Research Center of Transfusiology and Medical Biotechnologies, Minsk, BELARUS5, Emergency Hospital, Minsk, BELARUS6 Background. An ischemic stroke (IS) with coexisting multiple ñauses proves to receive much atten-tion. 452 © 2013 S. Karger AG, Basel Scientific Programme Methods. The clinical data were assessed in 129 patients with extracranial arteries atherosclero-sis and coexistence of multiple ñauses of IS. The relative content of T and B lymphocytes among peripheral blood mononuclear cells was analyzed by the flow cytofluorimetry using monoclonal antibodies CD3/CD4/CD8, CD4/154; CD19/CD40; CD25. An immunoregulatory index (IRI) was calculated as the ratio of CD4+ to CD8+. Cytomegalovirus, herpes simplex virus (HSV), varicella zoster virus, Helicobacter pylori, Mycoplasma pneumoniae, Chlamydia pneumoniaå im-munoglobu-lins (Ig) M were determined by an enzyme-linked immunosorbent assay. Results. IS was classified as due to one cause in 88 (68,2%) patients. Large artery disease (LAD), small artery disease (SAD) and cardiac source of embolism (CSE) were diagnosed in 38 (29,5%), 31 (24,0%) and 19 (14,7%) IS patients, respectively. Among 129 patients with IS 41 (31,8%) had at least two coexistence ñauses (CC), namely LAD+CSE (46,3%), LAD+SAD (46,3%), and CSE+ SAD (7,3%). Accord-ing to NIHSS data the patients with CC demonstrated more severe IS at ad-mission and slower recovery of neurological deficit with treatment as compared to the patients with one cause (p=0,014 and p= 0,005, respectively). These patients had higher incidence of multiple foci of cerebral infarction (p=0,01) and higher mortality (p=0,009). The IS patients with CC were found to have more cases of respiratory infections prior to stroke (p= 0,038). Of interest was more frequent detecting IgM antibodies to HSV in the serum of these pa-tients (p=0,003). Moreover, IRI was significantly lower (p=0,026), whereas the content of CD25+ was higher (p= 0,033) as compared to the IS patients with one cause. Conclusions. Our data support the importance of identifying coexisting causes in patients with an ischemic stroke in order to develop more accurate treatment and prevention strategy. 317 Etiology of stroke and risk factors A Study of Etiological profile of stroke in young adults T.S.K Kumar1, G.B.R Raju2, S.G Gopi3, E.S Sailaja4 Andhra Medical College, Visakhapatnam, INDIA1, Andhra Medical College, Visakhapatnam, INDIA2, Andhra Medicl College, Visakhapatnam, INDIA3, Andhra Medical college, Visakhapatnam, INDIA4 Background:The causes and risk factors of stroke in young individuals differs significantly from their older counterparts.Stroke in young will have economic burden on the individual,family and society in view of longer time to live with disability with loss of productive life compared with older individual.Methods:This hospital based prospective study is to evaluate the etiology, risk fac-tor profile, ischemic stroke subtypes in patients aged 15-45years with stroke.Major head trauma or surgery within 6weeks before event date, patients having subdural or epidural hematoma,diagnosis of mutiple sclerosis at any time in their medical records were excluded.Results:Total number of patients included were79 with mean age at presentation of 32(+/-10)years. Male to female ratio is 3:2.Mean age at presentation in males was 35years & females 27years.Hypertension,diabetes,dys-lipidemia was seen in 30(39%),6(8%),17(21%) patients respectively. Cardiac abnormalities were seen in 9 patients(15%). 94% of ischemic strokes were arterial. 95% of arterial strokes were isch-emic & 5%(4pts) were hemorrhagic.Hypertension was risk factor in all these patients.Large vessel atherosclerosis(20%) was most common in ischemic stroke followed by lacunar(16%),cardioem-bolic( 13%),neuroinfections (9%),hematological abnormalities(8%), nonatherosclerotic vasculop-athy( 8%),pregnancy related(4%). Intracranial vessel involvement was common in large vessel atherosclerotic strokes.Rheumatic heart disease was most common abnormality in cardioembolic stroke.Tuberculous meningitis was common among neuroinfections. Puerperal sinovenous occlusion was seen in 1patient.Hyperhomocystenemia was seen in 4patients.Takayasu’s arteritis was seen in 2patients.Moyamoya disease,coarctation of aorta,antithrombin-III deficiency,sickle cell disease were seen in 1patient each.Conclusions:Stroke in young age occured predominantly in males.Smoking & Hypertension were major risk factors and Large vessel atherosclerosis was the most common isch-emic stroke subtype in present study.
Karger_ESC London_2013
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