Inflammation plays an important role and is involved in all stages of acute ischemic stroke. One of these stages involves the recruitment of leukocytes from the peripheral circulation into the ischemic tissue. Lymphocytes as a subtype of leukocytes are important mediators and can become a predictor of neurological outcome. Several studies have been conducted regarding the correlation between differential lymphocyte counts and acute ischemic stroke. Most of these studies analyzed lymphocyte ratio to other leukocyte subtypes such as neutrophils and monocytes. This study specifically observed the role of lymphocytes as an indicator of the inflammatory response in patients with acute ischemic stroke. This study aimed to observe the correlation among risk factors, infarct location, leukocyte counts, lymphocyte value and neurologic output in acute ischemic stroke patients. Patients and Methods: We observed and analyzed 193 patients' data from medical record which met the inclusion and exclusion criteria with a diagnosis of acute ischemic stroke at the Department of Neurology of Dr. Hasan Sadikin General Bandung. Data were then analysed using appropriate statistical tests. Results: Most patients have more than one risk factor with a leukocyte count of less than 10,000 cell/mm 3 . Infarct was mostly located in subcortical area (basal ganglia), with moderate average NIHSS values at admission and at discharge. The number of lymphocytes decreased in the subject group with more than 10,000 cell/mm 3 leukocytes. Subsequently, data were analyzed using Spearman's test and there was a correlation between NIHSS on admission and lymphocyte depletion. Conclusion:The lymphocyte depletion in patients with leukocytosis is a predictor of poor NIHSS.
Purpose D-dimer is one of the main coagulation factors that plays a role in some diseases. Cerebral venous thrombosis (CVT) is a rare cerebrovascular disease with various clinical presentations, and the D-dimer might contribute to its clinical progress. Our study’s objective was to explore the association between D-dimer level and focal neurological deficits in selected CVT patients. Patients and Methods The patients’ data were retrospectively enrolled if they showed venous thrombus features in the digital subtraction angiography examination. Data collected were then evaluated using appropriate statistical tests. Results In a total of 30 patients, 24 patients had focal neurological deficits with abnormal D-dimer (mean 1.13±1.359 mg/L). We continued analysis to determine the association between the visual analog scale (VAS), a tool to measure the patient’s pain, and coagulation factors. There was no significant association between the VAS score and all the coagulation factors. Interestingly, a positive association was found between focal neurological deficits and abnormal D-dimer levels (p=0.009). Conclusion The abnormality of D-dimer levels in CVT’s patients associates with the incidence of focal neurological deficits.
Purpose Stroke is a significant cause of disability worldwide and is considered a disease caused by long-term exposure to lifestyle-related risk factors. These risk factors influence the first event of stroke and recurrent stroke events, which carry more significant risks for more severe disabilities. This study specifically compared the risk factors and neurological outcome of patients with recurrent ischemic stroke to those who had just experienced their first stroke among patients admitted to the Hospital. Patients and methods We observed and analyzed 300 patients’ data who met the inclusion and exclusion criteria. This retrospective observational study was conducted on consecutive acute ischemic stroke patients admitted to the top referral hospital, West Java, Indonesia. The data displayed are epidemiological characteristics, NIHSS score at admission and discharge, and the type and number of risk factors. Data were then analyzed using appropriate statistical tests. Results Most patients had more than one risk factor with hypertension as the most frequent (268 subjects or 89.3%). In patients who experienced ischemic stroke for the first time, the average National Institutes of Health Stroke Scale (NIHSS) score was lower (6.52 ± 3.55), and the alteration of NIHSS score was higher (1.22 ± 2.26) than those with recurrent stroke (6.96 ± 3.55) for NIHSS score and 1.21 ± 1.73 for alteration of NIHSS score). We processed the data with statistical analysis and showed a positive correlation between age (P < 0.05) and the number of risk factors (P < 0.001) in the recurrent ischemic stroke group. Conclusions Age and the number of risk factors correlate with recurrent ischemic strokes.
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