ETIOLOGY OF ISCHEMIC STROKE AND CORRELATION WITH COMMON RISK FACTORS IN A TERTIARY CARE CENTRE

Introduction: Stroke is the third leading cause of mortality worldwide and a matter of grave public importance in India. Ischemic stroke accounts for 80% of all cases. This study aims at classifying patients of ischemic stroke according to TOAST system. Aims and objectives: The specific objectives of the study are to document various etiology of ischemic stroke and correlate clinical presentations and risk factors with the different subtypes. Methodology: An observational study was carried out among 100 ischemic stroke patients using both prospective and retrospective data. History, clinical examination and different laboratory and radiological investigations were carried out. Etiology was classified by Trial of Org 10172 in Acute Stroke Treatment criteria and clinical presentations grouped by NIHSS score. Comparisons were done between groups stratified by stroke subtype. Results: Among the 100 patients 25 had cardioembolic, 13 large artery atherosclerosis, 21 small vessel stroke, 33 undetermined and 8 others type of stroke. Among the risk factors there was significant preponderance of hypertension, diabetes, ischemic heart disease, dyslipidemia, ECG, Echocardiographic abnormality, propensity for basal ganglia and paraventricular involvement among certain subtypes. There was no substantial relation between the subtypes and addictions, past history of stroke, and other territorial involvement. Conclusion: The etiological diagnosis of stroke in young adults has changed over time as a result of improvements in diagnostic workup. A notable portion of these patients remains without an evident stroke mechanism according to TOAST criteria.