Clinical Profile and Radiological Correlation of Recurrent Stroke

Background: Recurrent stroke is a new cerebrovascular event which occurs after the stabilization of the previous stroke. There is a wide range of clinical presentations and no significant difference between the first and recurrent strokes regarding the type of stroke. After stroke, survivors tend to focus on rehabilitation and recovery but preventing another stroke is a key concern. Systemic evaluation of recurrent stroke cases can help to identify risk factors, etiologies to choose the appropriate treatment and to reduce the risk of recurrence. Methods and materials: It was a descriptive cross-sectional study carried out at medicine and neuromedicine department of Dhaka Medical College and Hospital for 6 months, where a total of 100 patients were enrolled. Data was collected in questionnaire by interview who gave consent and fulfilled inclusion criteria. The collected data were analyzed using SPSS software. Result: Our study revealed that out of 100 patients, 72% were male and 28% were female, mean age 57.45 years, most were from 60-69 age group (44%).About 32% had completed higher secondary education and 46% belongs to lower middle class family. Most of the event occurred during daytime (44%) and about 47% respondents were sedentary workers. In present study,78% respondents suffered from ischaemic stroke and rest of them (22%) had haemorrhagic stroke. About 66 (66%) of them presented with hypertension,42(42%) with diabetes mellitus,46(46%) had dyslipidaemia and 35(35%) presented with heart diseases .Among the patient with heart diseases ,majority had IHD (63%,22),followed by arrhythmia(57%,20), valvular heart disease(54%,19) and congestive heart failure(CHF)(17%,6).Most of them(62%) were smoker,22% chewed betel nuts,12% chewed tobacco and 8% were alcoholic .Majority of the respondents presented with weakness of half of the body(68%) and GCS was more than 10 in 52 ischaemic stroke cases and 8 haemorrhagic stroke cases. In ischaemic stroke, middle cerebral artery(MCA) was involved in 71% cases, followed by posterior cerebral artery(PCA)(16%),anterior cerebral artery(8%), basilar artery(5%) and in haemorrhagic stroke, affected regions were basal ganglia, internal capsule and thalamus (55%,12),followed by temporo-parietal region(36%,8) and posterior fossa(9%,2). Conclusion: Present study finds out stroke type, risk factors, etiologies and radiological findings of recurrent stroke. A better understanding of the risk factors, etiologies could lead a better secondary prevention and thus will limit the future stroke burden in society.