Clinical and Radiological Profile of Acute Cerebrovascular Accident With Special Emphasis On Neurosurgical and Medical Methods in Management of ICH

Abstract

Introduction: Cerebrovascular accident  is a potentially lethal neurological disease of adult life. Intracerebral    hemorrhage is the  second most common subtype of stroke after ischemic stroke and accounts for approximately 10 % to 20 % of all strokes. Hypertension has been identified as the single most important risk factor causing intracerebral hemorrhage. Other risk factors include alcohol, smoking, diabetes, anticoagulant use and other genetic risk factors. The incidence of intracerebral hemorrhage increases with age and it is more among men and in Asians.  In acute stroke, CT scan readily distinguishes hemorrhage from infarct guiding anticoagulant therapy and site,  size of lesion provide prognostic value. Other stroke mimicking conditions can also be identified .TheICH score is a simple clinical grading scale that allows risk stratification on presentation with ICH. The role of surgery remains controversial in the management of acute intracranial hemorrhage.
Material &Methods: The present study was carried out  in the Department of Medicine, Sanjay Gandhi Memorial Hospital, Rewa between  April 2019 to June 2020 (15months). A total of  200  patients diagnosed with stroke were selected for the study.
Observations and Results: CVA is most commonly found among elderly patients. The most common clinical features was found to be weakness(47%) .In the present study most common type of stroke was ischemic stroke(63%) followed by hemorrhagic(23%).In the present study most common site of Ishemic stroke was internal capsule region (40.47%), followed by parietal lobe(20.63%) . The radiographic findings were favoring the middle cerebral artery territory involvement. In the present study, mortality for patients with an ICH score of 1,2,3,4 and 5 were 27.27%, 44.4%, 66.6%, 100%, 100% respectively. In the present study there was no significant difference between outcome of patients who were managed by neurosurgery and medical management.