Background: Atrial fibrillation (AF) is a common arrhythmia and a major risk factor for ischemic stroke, especially in the elderly patients. Patients with non-valvular AF have a 5-fold excess risk of stroke recurrence and case-fatality rate.Objectives: This study was to evaluate the prevalence of AF and its influence on prognosis in patients with ischemic stroke.Materials & Methods: Total 125 patients with ischaemic stroke were enrolled in this study. Initially they were divided into two groups by ECG - those with AF and those without AF. They were followed up after one month, three months and six months. Comparison was done between the two groups in term of recurrence, mortality and clinical improvement which were assessed by Modified Rankin Score (MRS).Results: Among 125 patients, 22 patients had AF. Those with AF were more frequently male, aged more than 45 years. Recurrence was significantly higher in AF group during one month follow up (p<0.05). The presence of AF was associated with higher mortality in 3 months (p<0.05) and 6 months (p<0.05) follow up. At 3 months follow up clinical deterioration was noted in 9.1% patient with AF compared to 2.9% patients without AF (p<0.01) and at 6 months follow up clinical deterioration was noted in 18.2% patient with AF compared to 4.9% patients without AF (p<0.01).Conclusion: Patients who had an ischemic stroke with accompanying AF had higher mortality, graver stroke severity, more recurrences and poorer functional status than those without AF.KYAMC Journal Vol. 8, No.-2, Jan 2018, Page 8-12

Abstract:Peripheral neuropathy is common in chronic renal failure patients and it '

Cerebral venous sinus thrombosis (CVST) is a rare form of brain stroke which is often misdiagnosed. We present a case of CVST due to cerebellar tuberculous abscess. A 41-year female patient was admitted with chronic occipital headache, diminished vision, and fever. The initial brain CT scan was negative, but subsequent imaging (MRI with MRV) showed cerebellar abscess with sigmoid sinus thrombosis. Fundoscopy revealed bilateral optic atrophy. Marked improvement (subjective and objective) was noted after 4 weeks with anti-tuberculosis chemotherapy and anticoagulants. Vision loss was irreversible due to optic atrophy. The case is extremely rare due to the location, rare causative organism (tuberculosis) and complex clinical presentation (occipital headache with vision loss).

Posterior reversible encephalopathy syndrome (PRES) is a reversible phenomenon diagnosed with both clinical and radiological criteria. We present anatypical case of PRES with unusual delayed reversal. A 29-year-old female presented withseizure and altered consciousness during post-partum periods. The initial computed tomographyscan of brain was normal. But subsequent magnetic resonance imaging of brain showed hyperintense lesion in rightparieto-occipital region. After 7 weeks of multidisciplinary team effort, the patient recovered both clinically and radiologically. High index of suspicion with long term follow up is crucial for this curable and reversible syndrome. Because of rarity in delayed recovery, this case of PRES is reported. Birdem Med J 2019; 9(3): 248-250

Idiopathic Intracranial Hypertension is a disease of unknown aetiology common in obese females and presents with headache, papilledema, raised CSF opening pressure, no abnormalities in CSF examination and no abnormality on CT scan or MRI of the Brain. Sinovenous abnormalities are commonly detected in patients of IIH by different neuroimaging techniques. But the exact role of these sinovenous abnormalities in the causation of the disease or whether they are an effect of the disease is not yet known. Nor has a ‘gold standard’ investigation been established yet for detection of the sinovenous abnormalities. This study was done to detect the presence of sinovenous abnormalities in IIH patients by performing a Magnetic Resonance Venography of the brain. All 33 patients of IIH who presented to Rajshahi Medical College Hospital during the study period from June 2009 to May 2010 were included in the study. There were 30 females and 3 males having a F:M ratio of 10:1. 91% of the patients were between 20 and 35 years of age and most of them were married housewives. 63.64% patients had history of use of oral contraceptives. Unusually 51.52% of the patients had a BMI less than 25 indicating that they were not even overweight (BMI 25 to 30). Only 6% of the patients had BMI > 30 indicating that they were obese. Headache and papilloedema were present in all patients but visual difficulties were present only in 54.54% of the patients. Abnormalities in MRV of the brain were detected in 27.27% (9/33) of the patients and transverse sinus hypoplasia was the commonest finding (88.89% - 8/9 patients). There was no statistically significant difference in the findings of MRV abnormalities between the males and females or among the patients having BMI less or more than 25TAJ 2013; 26: 53-56

‘Nothnagel Syndrome' is a brainstem syndrome which is often underdiagnosed by the physicians due to rarity of the disease and complex clinical presentation. We present a case of brainstem midbrain syndrome caused by ischemic stroke. The male hypertensive diabetic patient presented with sudden onset of diplopia, ptosis and gait imbalance. Right-sidedgaze palsy with nystagmus and ataxic gait were the clinical findings. Brain imaging (MRI and DWI) showed high signal intensity at upper midbrain. The patient was finally diagnosed as ischemic stroke in the brainstem called Nothnagel syndrome. Up to now, there was no case reported as Nothnagel Syndrome due to ischemic stroke. J MEDICINE JAN 2020; 21 (1) : 62-64

Background: Recognition of factors affecting morbidity and mortality of a disease helps in the proper management of a disease. CT scan of Brain is an essential investigation for all stroke patients. Identifying different characteristics of the CT findings of stroke patients which affect morbidity and mortality will help in the specific management of stroke patients. Thus this study was done to identify such factors from CT scan of Brain which will help in the proper management of stroke patients. Objectives: The aim of this present study was to determine the 7th and 28th days’ mortality rate of acute intracerebral hemorrhagic stroke and to determine the predictors of mortality. Methodology: Consecutive CT scan proven stroke patients following ICH were studied in the department of Radiology & Imaging at Rajshahi Medical College, Rajshahi, Bangladesh in collaboration with the Department of Neurology of Rajshahi Medical College, Rajshahi from January 2012 to December 2013. Site, size and volume of haematoma, midline shift, pineal gland displacement, hydrocephalus and intraventricular extension of haemorrhage were correlated with the mortality within 7th and 28th days of acute stroke. Risk factors like hypertension, smoking, diabetes and alcoholism were also recorded. Result: Ninety-nine consecutive CT scan proven stroke patients following ICH were studied. The 28-day mortality of intracerebral hemorrhage was 44.44% and it was 29.30% within the first 7 days of onset. Maximum number of death occurred in brainstem haemorrhage (75%), initial haematoma volume 61 to 80 ml (89.47%), >80 ml (91.7%), pineal gland displacement >3mm (79.5%), septum pellucidum displacement >5 mm (72.4%), ventricular extension (88.57%), and hydrocephalus (76.74%). Conclusion: The present study shows that deaths within 7th and 28th day of acute haemorrhagic stroke are correlated with the initial CT findings which could be regarded as a good predictor of mortality. Journal of National Institute of Neurosciences Bangladesh, 2019;5(1): 42-46

Stroke ranks first in frequency among all the neurological diseases of adult life and about 50% of all neurological disorders in a hospital are of this type. It is the third leading cause of death throughout the world. The purpose of the present study was to find out the presence or absence of haemorrhage or infarct and to detect the early signs of stroke on the basis of CT scanning. Three-hundred twenty one consecutive acute stroke patients (mean age 64 ±9.75 years) were included in our study. Each underwent cranial computed tomography without intravenous contrast injection within the first 24 hours. CT findings of stroke were analyzed using SPSS software. Among 321 patients, 209(65.11%) had ischemic stroke, 99(30.84%) had parenchymal haemorrhage and 13(4.05%) had subarachnoid haemorrhage. Total amount of haemorrhagic stroke was 112(34.89%). Early CT findings of ischaemic stroke were low attenuation area (83.25%), sulcal effacement (69.89%), loss of the insular ribbon (17.70%), hyperdense artery sign (1.43%). CT scanning should be the first line of investigation for diagnosis of acute stroke as it is more available than MRI and is easily performed in severely ill patients who are dependent on support and monitoring devices TAJ 2019; 32(1): 17-24