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1365 Ischemic Stroke in Hong Kong Chinese: profile, risk factors and outcome
Poster Abstracts
Thursday, November 10, 2005
$447
Results: The kinetic parameters and the FPPT behavior of different patients with chronic stroke reflected their hemiparetic gait pattern. The slower patients had prolonged stance and FPPT on the nonaffected side (NS) and prolonged swing and shorter FPPT on the affected side (AS). The magnitude of asyimnetry index of these parameters was associated with the severity of motor control impairment reflecting in a stereotyped, but quantitatively different manner, how much the control of the clinically healthy side (NS) was altered during walking. Conclusions: Bilateral changes were observed in gait parameters in the chronic stage of unilateral stroke. Tiffs may indicate bilateral brain reorganization in the presence o f motor deficit. However, the observed changes in kinetic and FPPT parameters of gait in both legs appeared to be more quantitative than qualitative; the gait variables altered in a stereotyped manner in relation to the degree of motor control disability in patients with chrordc stroke.
stroke severity, mean blood pressure (MBP) on admission, vital status at discharge (alive, dead), and outcome in survivors. Stroke severity was measured on admission using the National Institute of Health Stroke scale (NIHSS). Functional outcome was measured at discharge with Rankin scale. Results: 41 patients had seizures within the first 48 hours of onset of stroke. Mortality was 73.2%. 33 patients (80.5%) have an NIHSS score > 10 that was well related with a Glasgow Coma Scale (GCS) < 8 and a MBP > 130 ro_mHg on admission. Of the 11 survivors, only 36.4°,5 have a higher disability rating (Rankin scale > 3). Conclusion: Seizures at onset were well correlated with stroke severity in acute phase and are also a good predictive factor o f mortality. Seizures at stroke onset may help clinicians to establish a clinical and functional prognosis more accurately.
1363 Peculiarities of Cognitive Deficiency in Dysehrcolatory Eneephalopathy
Tsang, K 1, Koo, Y, Wong T 1. 1Department of Medicine, Tseung Kwan
Toktomusheva, A ~. 1Kyrgyz-Russian Slavic University, Bishkek,
Kyrgyzs tart 60 patients of the age 40-75,/34- males, 26- females were examined by EEG, Ultrasound, ECG, REG, MRI, ophthalmoscope. Patients with attendant illness (diabetes, cerebral trauma, alcoholism, thyrotoxicosts) were excluded from the research. Results: Based on instrmnental examination of patients with atherosclerotical dysdrculatory encephalopathy 29; hypertensive type 24; venous type 7 were picked out. The peculiarities of patients with venous type were that they had been inhabitants of the high altitude zone ( h > 2200 m. above the sea level), also they more than 5 years suffered from the chronicle obstructive pulmonary diseases and had signs of pulmonary arterial hypertension (147-+2.1 ram) with hypertrophy o f right heart ventricle (5.38-+0.16 nun); R E G and ophthalmoscope showed stagnant venous occurrence. In neurological status they had moderate coordinative disorders, hearing deficiency with giddiness, night dispnoe, periodical somnolence, headaches after sleep, or coughing and others multiple orgatfical symptoms. Neuropsychological test of patients revealed deceleration of mental activity, difficulties in generalization, deficiency of short memory, weariness of attention/concentration, asthenic emotional background, pathological sluggishness, impulsive, modal nonspecific decrease of memory, difficulties in construction and fulfillment of complex tasks, att.xdous depressive syndrome, elements of apraxia, acalculia, aguosia, aphasia. Some neurologists accentuate on intellectual deficiency (vascular dementia), others - on neurological disorders (vascular Parkinsonism, vascular pseudobulbarial syndrome, vascular disuria). It is assumed that the appropriate level of combination of neurological being primary and psychological (cogtfitive, emotional, personal) syndromes during the different stages and types of vascular encephalopathy will assist the earlier diagnosis and adequately treat the illness. 1364 Prognostic value of seizures in Acute Stroke phase To~iente, M ~, Asencio, A 1. i f alia Trigo University Hospital, Havana
City, Cuba Background: Despite the common occurrence of seizures during the early phase of stroke, its effect on prognosis is not well known. The objective of this study is to evaluate seizures in early stroke phase and their relationship with stroke outcome. Also to identify possible associated predictors. Method: 148 patients were prospectively and consecutively studied with acute stroke. The analyzed data were type of seizures, irdtial
1365 ISdleUdC Stroke in Hong Kong ChineSe: protile, risk factors and outcome
0 Hospital, l-long Kong SAR Background: Profile and risk factors for ischemic stroke in Asians were believed to be different and most updated information is scarce. The present study was to determine the clinical characteristics and one-year outcome of Hong Kong Chinese ischemic stroke patients and to study its correlation with various admission biochemical parameters. Methods: All Chinese ischemic stroke patients admitted to a regional hospital over one year were prospectively followed. Results: There were 428 patients, with mean age being 71.6 ± 11.5 years and male to female ratio of 1.15 to 1. Stroke subtypes were divided according to the Bamford classification: lacunar (161.0%), total anterior circulation (112.4%), partial anterior circulation (10.0%) and posterior circulation (16.6%) strokes. The prevalence of common risk factors was: hypertension (77.1%), diabetes (34.6°,5), old stroke (33.4%), atrial fibrillation (19.4°,5), ischemic heart disease (11.4%) and active smoking (11.9%). The mean admission hemoglobin, hematocrit, glucose, low-density lipoprotein and triglyceride levels were 13.4 ± 1.9g/dL, 0.39 ± 0.05, 7.9 ± 4.1 m_mol/L, 3.3 ± 1.0 m_mol/L, 1.7 ± 1.1 mmol/L respectively. At one year, recurrent strokes occurred in 10.0°,5 and the overall mortality was 15.9%. Ttfirty percent patients were in dependent state (modified Rankin Scale [mRS] 4-5) at one year while 54.6% had mRS <3. By bivariate correlation, low hemoglobin level was associated with worse outcome (r - -0.22). Other admission biochemical criteria did not predict prognosis, even when stroke subtypes or other etiologies were taken into account. Conclusions; The stroke subtypes and outcome were similar to other reported ischemic stroke series, but unlike some epidemiologic studies, the admission biochemistry could not predict long-term outcome.
1366 The correlation between Aherosclerotic Lesion's extension and prognosis in patients with Stroke Tufanoiu E 1.
1
Fundeni Clinical Institule, Clinic of Neurology, Bucharest,
Romania Background: In a previous work we found a different mortality in elderly (172%) versus younger (14,5%). In tiffs work we are searching if there is a correlation between the extension of the vascular lesion and the rate of mortality at 30 days. Method: The sample included 19 patients over 80-years old (11 females and 8 males) and 18 under 60-years old (8 females and 10 males) with anterior stroke. They were explored non-invasive through fluoroscopy, echocardiography, transesophagial Doppler and extra cranial carotidian Doppler. The patients with atrium fibrillation and with diabetes mellitus were excluded fi'om study. Results: More than 80% fi'om the 80 years old patients have presented modifications on carotidian Doppler, transesophageal Doppler and
Thursday, November 10, 2005
$447
Results: The kinetic parameters and the FPPT behavior of different patients with chronic stroke reflected their hemiparetic gait pattern. The slower patients had prolonged stance and FPPT on the nonaffected side (NS) and prolonged swing and shorter FPPT on the affected side (AS). The magnitude of asyimnetry index of these parameters was associated with the severity of motor control impairment reflecting in a stereotyped, but quantitatively different manner, how much the control of the clinically healthy side (NS) was altered during walking. Conclusions: Bilateral changes were observed in gait parameters in the chronic stage of unilateral stroke. Tiffs may indicate bilateral brain reorganization in the presence o f motor deficit. However, the observed changes in kinetic and FPPT parameters of gait in both legs appeared to be more quantitative than qualitative; the gait variables altered in a stereotyped manner in relation to the degree of motor control disability in patients with chrordc stroke.
stroke severity, mean blood pressure (MBP) on admission, vital status at discharge (alive, dead), and outcome in survivors. Stroke severity was measured on admission using the National Institute of Health Stroke scale (NIHSS). Functional outcome was measured at discharge with Rankin scale. Results: 41 patients had seizures within the first 48 hours of onset of stroke. Mortality was 73.2%. 33 patients (80.5%) have an NIHSS score > 10 that was well related with a Glasgow Coma Scale (GCS) < 8 and a MBP > 130 ro_mHg on admission. Of the 11 survivors, only 36.4°,5 have a higher disability rating (Rankin scale > 3). Conclusion: Seizures at onset were well correlated with stroke severity in acute phase and are also a good predictive factor o f mortality. Seizures at stroke onset may help clinicians to establish a clinical and functional prognosis more accurately.
1363 Peculiarities of Cognitive Deficiency in Dysehrcolatory Eneephalopathy
Tsang, K 1, Koo, Y, Wong T 1. 1Department of Medicine, Tseung Kwan
Toktomusheva, A ~. 1Kyrgyz-Russian Slavic University, Bishkek,
Kyrgyzs tart 60 patients of the age 40-75,/34- males, 26- females were examined by EEG, Ultrasound, ECG, REG, MRI, ophthalmoscope. Patients with attendant illness (diabetes, cerebral trauma, alcoholism, thyrotoxicosts) were excluded from the research. Results: Based on instrmnental examination of patients with atherosclerotical dysdrculatory encephalopathy 29; hypertensive type 24; venous type 7 were picked out. The peculiarities of patients with venous type were that they had been inhabitants of the high altitude zone ( h > 2200 m. above the sea level), also they more than 5 years suffered from the chronicle obstructive pulmonary diseases and had signs of pulmonary arterial hypertension (147-+2.1 ram) with hypertrophy o f right heart ventricle (5.38-+0.16 nun); R E G and ophthalmoscope showed stagnant venous occurrence. In neurological status they had moderate coordinative disorders, hearing deficiency with giddiness, night dispnoe, periodical somnolence, headaches after sleep, or coughing and others multiple orgatfical symptoms. Neuropsychological test of patients revealed deceleration of mental activity, difficulties in generalization, deficiency of short memory, weariness of attention/concentration, asthenic emotional background, pathological sluggishness, impulsive, modal nonspecific decrease of memory, difficulties in construction and fulfillment of complex tasks, att.xdous depressive syndrome, elements of apraxia, acalculia, aguosia, aphasia. Some neurologists accentuate on intellectual deficiency (vascular dementia), others - on neurological disorders (vascular Parkinsonism, vascular pseudobulbarial syndrome, vascular disuria). It is assumed that the appropriate level of combination of neurological being primary and psychological (cogtfitive, emotional, personal) syndromes during the different stages and types of vascular encephalopathy will assist the earlier diagnosis and adequately treat the illness. 1364 Prognostic value of seizures in Acute Stroke phase To~iente, M ~, Asencio, A 1. i f alia Trigo University Hospital, Havana
City, Cuba Background: Despite the common occurrence of seizures during the early phase of stroke, its effect on prognosis is not well known. The objective of this study is to evaluate seizures in early stroke phase and their relationship with stroke outcome. Also to identify possible associated predictors. Method: 148 patients were prospectively and consecutively studied with acute stroke. The analyzed data were type of seizures, irdtial
1365 ISdleUdC Stroke in Hong Kong ChineSe: protile, risk factors and outcome
0 Hospital, l-long Kong SAR Background: Profile and risk factors for ischemic stroke in Asians were believed to be different and most updated information is scarce. The present study was to determine the clinical characteristics and one-year outcome of Hong Kong Chinese ischemic stroke patients and to study its correlation with various admission biochemical parameters. Methods: All Chinese ischemic stroke patients admitted to a regional hospital over one year were prospectively followed. Results: There were 428 patients, with mean age being 71.6 ± 11.5 years and male to female ratio of 1.15 to 1. Stroke subtypes were divided according to the Bamford classification: lacunar (161.0%), total anterior circulation (112.4%), partial anterior circulation (10.0%) and posterior circulation (16.6%) strokes. The prevalence of common risk factors was: hypertension (77.1%), diabetes (34.6°,5), old stroke (33.4%), atrial fibrillation (19.4°,5), ischemic heart disease (11.4%) and active smoking (11.9%). The mean admission hemoglobin, hematocrit, glucose, low-density lipoprotein and triglyceride levels were 13.4 ± 1.9g/dL, 0.39 ± 0.05, 7.9 ± 4.1 m_mol/L, 3.3 ± 1.0 m_mol/L, 1.7 ± 1.1 mmol/L respectively. At one year, recurrent strokes occurred in 10.0°,5 and the overall mortality was 15.9%. Ttfirty percent patients were in dependent state (modified Rankin Scale [mRS] 4-5) at one year while 54.6% had mRS <3. By bivariate correlation, low hemoglobin level was associated with worse outcome (r - -0.22). Other admission biochemical criteria did not predict prognosis, even when stroke subtypes or other etiologies were taken into account. Conclusions; The stroke subtypes and outcome were similar to other reported ischemic stroke series, but unlike some epidemiologic studies, the admission biochemistry could not predict long-term outcome.
1366 The correlation between Aherosclerotic Lesion's extension and prognosis in patients with Stroke Tufanoiu E 1.
1
Fundeni Clinical Institule, Clinic of Neurology, Bucharest,
Romania Background: In a previous work we found a different mortality in elderly (172%) versus younger (14,5%). In tiffs work we are searching if there is a correlation between the extension of the vascular lesion and the rate of mortality at 30 days. Method: The sample included 19 patients over 80-years old (11 females and 8 males) and 18 under 60-years old (8 females and 10 males) with anterior stroke. They were explored non-invasive through fluoroscopy, echocardiography, transesophagial Doppler and extra cranial carotidian Doppler. The patients with atrium fibrillation and with diabetes mellitus were excluded fi'om study. Results: More than 80% fi'om the 80 years old patients have presented modifications on carotidian Doppler, transesophageal Doppler and