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ORIGINAL ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 3  |  Page : 155-159

Assessment of intracranial and extracranial atherosclerosis in patients presenting with acute ischaemic stroke


1 Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
2 Department of Radiology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India

Correspondence Address:
B Vengamma
Director-Cum Vice-Chancellor, Senior Professor and Head, Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JCSR.JCSR_85_19

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Background: Few Indian studies are available which have examined the risk factors and extracranial and intracranial vascular observations in patients with stroke. Methods: We prospectively studied the burden of intracranial atherosclerosis (ICAS) and extracranial atherosclerosis (ECAS) in patients (n = 300) with acute ischaemic stroke and study the vascular disease to the outcome of the patients. Results: Their mean age was 57.8 ± 14.2 years; there were 183 (61%) males. The frequency of risk factors were hypertension (73%), diabetes mellitus (46%), tobacco smoking (34%), dyslipidaemia (39.3%), alcoholism (27%), previous stroke (21%), chronic kidney disease (CKD) (9%) and hyperhomocystinaemia (15%). Multiple and single territory infarction was evident in 103 (34.3%) and 197 (65.7%), respectively. Both ICAS and ECAS were evident in 117 (39%), whereas 111 (37%) had ICAS and 36 (12%) had ECAS. On univariate analysis, the presence of CKD (P = 0.01), previous stroke (P = 0.02), ICAS and combined ICAS plus ECAS were associated with unfavourable outcome (P = 0.0001). On multivariable analysis, age >58 years (odds ratio [OR] 1.04, 95% confidence intervals [CI] 0.71–0.89, P < 0.0001), female gender (OR 0.6, 95% CI 0.41–0.87, P = 0.008), National Institutes of Health Stroke Scale score >18 (OR 0.75, 95% CI (0.71–0.80, P < 0.0001) were associated poor functional outcome. Conclusions: ICAS was more common than ECAS. ICAS and combined ICAS plus ECAS were associated with unfavourable outcome.


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