Comparison of Ischemic and Hemorrhagic Stroke in the Medical Ward of Dessie Referral Hospital, Northeast Ethiopia: A Retrospective Study

Abstract

Background. Distinguishing the category of stroke plays a vital role in planning patient care. Simple clinical findings help distinguish the type of stroke. However, there is a need for diagnostic imaging. In Ethiopia, stroke is the most common neurological condition in patients admitted to hospitals. Yet, there are limited data on comparisons of stroke subtypes. Thus, this study was designed to determine the prevalence of stroke and to compare ischemic and hemorrhagic strokes. Methods. A retrospective cross-sectional study design was employed. Medical records containing complete information and confirmed diagnosis using imaging techniques were included. The data were entered into SPSS version 24.0 for analysis. Results with a P value of <0.05 were considered statistically significant. Results. From a total of 312 stroke patients, 204 (65.4%) patients were admitted due to ischemic stroke. More females, 59 (18.9%), were admitted for hemorrhagic stroke than males. In both ischemic, 175 (56.1%) and hemorrhagic, 91 (29.2%) stroke cases, most of the patients were 45 years and above. Middle cerebral artery territory was the most common site of arterial territory infarctions in ischemic stroke, 158 (50.7%). Middle cerebral artery territory also was the most common site of hematoma in hemorrhagic stroke, 91 (29.2%). Infarctions in more than one lobe of the cerebrum (16.4%) and intracerebral hemorrhage in multiple areas of the cerebrum (7.4%) were observed in ischemic as well as hemorrhagic stroke cases. Most of the ischemic, 124 (39.8%), and hemorrhagic, 39 (12.5%), stroke patients presented loss of sensation and weakness of body parts. Hypertension was observed in 124 (39.8%) ischemic and 73 (23.4%) hemorrhagic stroke patients. The mortality rate of ischemic stroke, 47 (15.3%), was two times higher than hemorrhagic stroke, 20 (6.5%). Hypertension was the most common predictor of death in both ischemic and hemorrhagic stroke cases. Conclusions. Ischemic stroke is a common type of stroke in the medical ward of the study hospital. More females were affected by hemorrhagic stroke than males. Middle cerebral artery territory was the most affected area of the brain in both ischemic and hemorrhagic strokes. Most ischemic and hemorrhagic stroke patients were admitted due to loss of sensation and weakness of body parts. Hypertension was the most common risk factor of stroke as well as a predictor of stroke-related deaths. Identification of the stroke subtypes may be important in the management of stroke. Thus, health professionals, government officials, community leaders, and the population at large could be involved in creating awareness about antecedent risk factors and clinical presentations of stroke subtypes.

Comparison among demographics, risk factors, clinical manifestations, and outcomes of stroke subtypes: Findings from a Malaysian stroke-ready hospital

“…We also found that marital status was not associated with IS and HS and the finding aligned with a study conducted at Northeast Ethiopia. 25 Our study indicated that IS patients had a higher prevalence of vascular RFs such as diabetes, hyperlipidaemia, and IHD as opposed to HS patients. In the general population, hypertension is one of the most significant RF for stroke, and the risk of stroke rises linearly as blood pressure rises above 115/75 mmHg.…”

The Development of Novel Drug Treatments for Stroke Patients: A Review

“…Structural abnormalities in blood vessels during the brain development stage could also increase a person’s chances of developing hemorrhagic stroke. This type of stroke affects more females than males [ 11 ].…”

Biological Properties and Clinical Significance of Lipoprotein-Associated Phospholipase A2 in Ischemic Stroke

“…Based on data from the Global Burden of Disease Study 2019 (https://www .healthdata.org), stroke is the second leading cause of disability and mortality worldwide (Figure 1). Stroke is normally classified into two subtypes: hemorrhagic stroke and ischemic stroke [3,4]. A hemorrhagic stroke occurs when a blood vessel ruptures and bleeds into the brain [3,4].…”

“…Stroke is normally classified into two subtypes: hemorrhagic stroke and ischemic stroke [3,4]. A hemorrhagic stroke occurs when a blood vessel ruptures and bleeds into the brain [3,4]. An ischemic stroke, which accounts for most cases (nearly 87%) [5,6], is characterized by a sudden loss of blood circulation due to blockage of an artery [5,6].…”

“…In response to this, a very important strategy is to conduct in-depth research on the mechanisms of stroke occurrence and development, identify some key therapeutic targets, and develop drugs against these targets. Evaluation of ischemic stroke risks and treatment are both important in decreasing the global burden [3,5,8]. Accumulated evidence has proven that both Lp-PLA 2 activity and mass are independent biomarkers of ischemic stroke and cardiovascular disease [29].…”