Introduction – With increasing life expectancy and changing trends in diseases, lifestyle diseases come forward and become a major concern. Ischemic stroke is an emerging public health issue leading to significant morbidity and mortality. To improvise positive outcome in acute ischemic stroke (AIS) and optimizing healthcare resources, accurate and timed prognostication of functional outcome is important. Various studies implied derangement of Hypothalamo- pituitary-thyroid (HPT) axis in AIS, thereby advocates neuroprotective properties to these hormones. This is, still, an open field for active research. Thyroid hormones can, therefore, be used as a surrogate tool for outcome predilection in AIS. This prospective observational cohort study aimed to investigate the alteration of levels of thyroid hormones in AIS and simultaneously correlate their levels in assessment of clinical severity and predicting the functional outcome. Materials and methods – We had collected data from 60 patients of, radiologically confirmed new cases of AIS who sought medical help within 72 hours of initiation of stroke symptom and had no previous history of thyroid disease. Blood samples for thyroid function test [TSH, FreeT3 (FT3), and FreeT4 (FT4)] were collected within 24 hours after admission and subsequently at 7th and 30th day of discharge .On admission neurological clinical severity was assessed by using National Institute of Health Stroke Scale (NIHSS). Functional outcome was assessed by Modified Rankin Scale (mRS) at 7th and 30th day of discharge. Result – Out of 60 AIS patients, 40 were having Non thyroidal illness Syndrome (NTIS). Low T3 was most common NTIS observed. Negative correlation was observed between FT3 levels and on admission NIHSS score and mRS score on follow up. Conclusion – This study thereby concludes that low T3 levels were associated with clinical severity and poor functional outcome in AIS.
Moyamoya disease is a rare affliction, which progressively affects cerebral arteries, more frequently those in the circle of Willis and the internal carotid arteries. This condition has a genetic component, but the cause of the disease is unknown. It usually affects children but can affect adults as well, representing a health issue due to its mortality. Not in a few cases, Moyamoya disease has been difficult to recognize as a cause of ischemic or hemorrhagic strokes. In this article, we present the case of a young patient, with a medical history of cerebral hemorrhage, which was diagnosed with Moyamoya disease after clinical and cerebral angiographic corroboration in a specialized vascular center. The patient entered the Emergency Receiving Unit with a sudden comatose state. Paraclinical tests revealed massive intraparenchymal hemorrhage, with movement in the medial line and ventricular flooding.
Stroke has a significant prevalence in Romania. The predisposition for this multifactorial disease is partially known. The aim of this study is to investigate the predisposition for stroke in Romanian population. Material and methods. We selected cases with recent ischemic stroke (n=100) and healthy control subjects (n=100). The AGTR1 A1166C (rs5186) polymorphism was genotyped by restriction of amplicons with Dde I endonuclease. Results. Active cigarette smoking (O.R. =6.92, p=0.0001) or presence of the AT1R C variant (O.R. =6.69, p=0.0006) in overweight or obese women significantly increase the risk for ischemic stroke. The diagnosis of stroke (71.5 vs 68 years old) or T2DM (63.39 vs 60.77 years old) was recorded at an older age in women compared to men (p<0.05). Obesity considered independent (O.R. =4.22, p<0.05) or in association with T2DM (O.R. = 10.16, p=0.0002) confers the highest risk of stroke when compared to women. Conclusions. Obesity in association with T2DM confers the highest risk of stroke for men when compared to women. Active cigarette smoking or AT1R C variant significantly increase the risk for stroke in women with a high BMI compared with controls.
There is a potential lateralization of vegetative influences at the cerebral level. We sought to understand the impact of these influences in the setting of ischemic stroke. We conducted a prospective study on 110 who presented with acute ischemic stroke (symptom onset maximum 24 hours before admission). We investigated correlations between stroke subtype, insular location or lateralization, stroke severity, hospital mortality, and the dynamic of enzymes (Tn, TnT, CK, CK-MB). We demonstrated that a higher cardiac enzyme value is associated either with stroke severity or with a higher risk of death in the short term, this growth being a marker for a more severe prognosis of a large stroke rather than an independent cause of mortality. Cardiac monitoring in the acute phase of ischemic stroke can prevent cardiac morbidity and mortality, which is why it is important to identify patients at high risk of heart complications after stroke.
