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Tracking of mesenchymal stem cells labeled with Gd-Dtpa by Mr imaging in cerebral ischemia model
Abstracts / Journal of the Neurological Sciences 333 (2013) e152–e214
Background: Despite extensive investigations in the stroke medicine, still there is little known about the course of spontaneous intracerebral haemorrhage (SICH) in the very elderly. Material and methods: A retrospective study of 231 consecutive cases diagnosed with SICH was carried out in the Department of Neurology at the Medical University of Warsaw. A case control study included patients with SICH aged ≥80 years. Data on risk factors, clinical presentation, neuroimaging and outcomes were collected and statistically analysed. Results: The whole studied population consisted of 231 patients (52%male): 66 aged ≥80 years and 165 b 80 years of age. There were more female cases among the very elderly (65% vs 46%, p = 0.009). Hypertension was the most common risk factor in both age groups (p = 0.21). Coronary artery disease and atrial fibrillation were statistically more frequent in the elderly (CAD:p b 0.001; AF:p b 0.001). No significant differences were observed in GCS score or the SICH site. Larger hematoma size (3.6 cm vs 3.2 cm, p = 0.04) and more frequent occurrence of intraventricular extension (IVH) (41% vs 24%, p = 0.05) were found in patients aged ≥80 years. The mortality rate was higher in the older patients (in-hospital mortality: 40.9% vs 15.2%, 30-day mortality: 33.3% and 13.3%; both p = 0.02). Hematoma size predicted in-hospital case fatality in the very elderly (p = 0.005), whereas hematoma size and GCS score had predictive value in patients aged b80 years (p = 0.001 and p = 0.017, respectively). Conclusion: The very elderly patients with SICH are a high risk group as far as clinical outcomes and prognosis is concerned. Hematoma size seems to be the most powerful parameter in predicting early mortality. Further prospective studies are needed to identify prognostic factors in this subpopulation. doi:10.1016/j.jns.2013.07.699
Abstract — WCN 2013 No: 605 Topic: 3 — Stroke Prevalence and radiological peculiarities of metabolic syndrome and hypertension in stroke patients M. Kapianidze, M. Janelidze, N. Mikava, N. Kvirkvelia, N. Lobjanidze, S. Kapianidze, N. Akiashvili, T. Maisuradze. Neurology, S. Khechinashvili Medical University Hospital, Tbilisi, Georgia Background and purpose: Hypertension, obesity and diabetes (metabolic syndrome) are significant risk factors of stroke. A better understanding of relation between metabolic syndrome and hypertension may lead to the reduction of cerebrovascular risks and improve the stroke treatment and outcome as well. Methods: A total of 345 (F = 198, 69.7 ± 5.3) patients with acute stroke were investigated. Diagnosis of Metabolic syndrome (MetS) was ascertained according to the revised National Cholesterol Education Program Adult Treatment Panel III (ATP III-r). Stroke was diagnosed using NIHSS criteria. Type, side and site of stroke were assessed by MRI. Hypertension (HYP) was defined according to cardiovascular criteria, based on target organ damage. In addition to hypertension, other modifiable and non-modifiable risk factors were recorded. Neuropsychological battery and MMSE tests were performed in the target population. The data statistically evaluated by SPSS-11.0. Results: Among stroke patients 124/35.9% found to have MetS, 106/ 85.4% diagnosed as ischemic stroke with lacunar or multiple brain lesions. Most of the patients with female preponderance (76) had moderate to severe leucoaraiosis (71%), mild-to moderate cognitive disturbances (54%) and dementia (14%). The HYP and obesity alone146/42.3% patients had more haemorrhagic stroke (79/54.1%) with male dominance and psychological disturbances, such as depression (46%) or depression-anxiety disorders (31%).
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Conclusions: Mets may be considered as independent risk factor for ischemia and dementia (P N 0.001), while the Hypertension and obesity alone may carry the risk of bleeding and neuropsychological disturbances (P N 0.001). doi:10.1016/j.jns.2013.07.700
Abstract — WCN 2013 No: 607 Topic: 3 — Stroke Comparison of comorbidity of hypertension and mild cognitive impairment in atrial fibrilation's patients after stroke and miocardial infarction M. Kapianidze, N. Akiashvili, M. Janelidze, S. Kapianidze, N. Kvirkvelia, N. Lobjanidze, T. Maisuradze, N. Mikava. Neurology, S. Khechinashvili Medical University Hospital, Tbilisi, Georgia Background: Mild Cognitive Impairment is the frequent sequela of patients with neurovascular and cardiovascular disorders, especially patients with Atrial Fibrilation and may lead to vascular dementia. Aim: The aim of the study was to establish the role Hypertension on development of MCI after stroke and Miocardial Infarction. Methods: 192(93/99) poststroke and post-MI patients with AF were investigated and underwent MRI scan. Cognition and daily activity evaluated by MMSE, ADL Index, Cognitive function investigated by neuropsychological battery test and acute phase and after 3 months. Depression was evaluated by Hamilton Depression Rating Scale. According to the test data both neurological (after Stroke) and cardiovascular (after Miocardial Infarction) patients with atrial fibrilation were separately divided in III groups: I — MCI alone, II — Hypertension alone, III — MCI + Hypertension. Groups did not differ due to vascular risk-factors and demographic variables. Results: From patients with MI–MCI and Hypertension alone was diagnosed in 56 (56.5%) and 38 (38.3%), but after Stroke in 42 (45.1%) and 76 (81.7%) cases respectively. Hypertension + MCI — were revealed after MI in 42 (42.2%) and postStroke in 68 (71.1%) cases, — Comparision of both groups revealed that Hypertension +MCI and Hypertension alone have more frequently were in poststroke group as well as ADL Index and MMSE, but depression alone 58 (58.5%) and Executive Dysfunction Syndrome alone 63 (63.6%) more frequently as well their comorbidity (34/34.3%) in cardiac patients vs poststroke. (p b 0.05).which were correlated with multiple lacunar silent damage radiologically. Conclusion: In AF-poststroke patients more demented and hypertensive (OR 9.90, P = 0.031), but the AF-MI patients have more frequently mild cognitive decline and depression (OR 8,9, P N0.001). doi:10.1016/j.jns.2013.07.701
Abstract — WCN 2013 No: 619 Topic: 3 — Stroke Tracking of mesenchymal stem cells labeled with Gd-Dtpa by Mr imaging in cerebral ischemia model K. Genga, D.X. Huanga, R.H. Wub. aShantou University Medical College, 2nd Affiliated Hospital of Shantou University Medical College, Shantou, China; bDepartment of Medical Imaging, 2nd Affiliated Hospital of Shantou University Medical College, Shantou, China Objective: Recent developments in stem cell and gene therapy will require methods to monitor stem cell survival and integration repeatedly and non-invasively with a high temporal and spatial
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Abstracts / Journal of the Neurological Sciences 333 (2013) e152–e214
resolution in vivo. The aim of the study was to explore the possibility of the rat mesenchymal stem cells (MSCs) labeled with standard contrast agents (Gd-DTPA) for stem cell tracking. Methods: MSCs from bilateral femur of rats were cultured and propagated. Intracellular uptake of Gd-DTPA was achieved by using a non-liposomal lipid transfection reagent (Effectene) as the transfection agent. Electron microscopy was performed to detect the distribution of Gd-DTPA particles in MSCs, and labeling efficiency of Gd-DTPA particles on MSCs was evaluated using spectrophotometric. Viability and proliferation of labeled MSCs were evaluated using MTT assay. Labeled MSCs were detected with T1-weighed MR imaging in vitro and in rat brain. Results: The presence of Gd-DTPA particles inside the MSCs was definitely detected by transmission electron microscopy. Labeling efficiency was highly. There was no difference in viability and proliferation between the labeled and unlabeled confirmed by MTT values of light absorption. The labeled MSCs demonstrated the high signal intensity on T1-weighted MRI in vitro and in rat brain. Conclusion: Rat MSCs can be labeled with Gd-DTPA particles without changing the cell viability and proliferation. Obviously labeled MSCs can be imaged in vitro and vivo. Gd-DTPA shows no evident adverse effect on the function of labeled MSCs. Gd-DTPA can be used for the MR imaging tracking of labeled MSCs. doi:10.1016/j.jns.2013.07.702
Abstract — WCN 2013 No: 637 Topic: 3 — Stroke Epidemiology of stroke risk factors in Belarus H. Lushchyk, S. Likhachev. Neurological Department, State Institution ‘Republic Scientific Practical Centre of Neurology and Neurosurgery’, Minsk, Belarus Background: Stroke is one of the leading causes of death. Death from stroke in people of working age is particularly alarming. Studying the prevalence of stroke risk factors will help develop an optimal system for prophylaxis thus reducing morbidity and mortality from stroke. Objective: The aim of the study was to study prevalence of stroke risk factors among people of working age. Patients and methods: Using a specially developed standardized questionnaire card we carried out the screening of open population. We examined 189 people aged between 40 and 62 years (mean age 51.68 years) of one of the district polyclinics in Minsk, including 135 women (71.43%) and 54 men (28.57%). Results: The following risk factors were revealed: · Overweight — 128 people (67.72%), including 66 people with a BMI of 26–29 (34.92%) and 62 people with a BMI ≥30 (32.8%); · Arterial hypertension — 87 people (46.03%), including 33 people with hypertensive crisis in medical history; · Family history of hypertension before the age of 60 years — 98 people (51.85%); · Hypodynamia — 71 people (37.57%); · Smoking — 46 people (24.34%); · Coronary heart disease — 35 people (18.52%); · Family history of stroke/heart attack before the age of 60 years — 31 people (16.4%); · Diabetes mellitus — 11 people (5.82%); · Alcohol abuse — 7 people (3.7%). Conclusion: The most common stroke risk factors in the studied population are overweight, hypertension and hypodynamia. Particularly disturbing is the fact that only 44 people (50.57%) with hypertension regularly take antihypertensive medication. doi:10.1016/j.jns.2013.07.703
Abstract — WCN 2013 No: 470 Topic: 3 — Stroke The prevalence and association with cerebrovascular risk factors of cerebral microbleeds in Korean ischemic stroke patients E.J. Choi, T.-W. Kim, J.-S. Kim. Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea Background and Purpose: Advanced age, presence of intracerebral hemorrhage or ischemic stroke, dementia, hypertension, and use of antithrombotic therapy have been reported to be associated with a higher risk of cerebral microbleeds. In addition, the severity of white matter hyperintensity (WMH) was known to be associated with cerebral microbleeds. We tried to investigate the frequency and the number of mirobleeds in Korean ischemic stroke patients and risk factors as well as their relationship to microbleeds. Methods: Four hundred subjects (mean age ± SD: 66.5 ± 13.5) visited for acute cerebral infarctions or transient ischemic attacks were enrolled in this study. For each subject, we researched the baseline demographic characteristics, cerebrovascular risk factors, the number and localization of the microbleeds or WMHs. Results: The prevalence of mirobleeds in this study was 31%. We revealed that male gender, history of heart disease and WMH acted as burdens of microbleeds. After regional subdivision, hypertension was a risk factor for microbleeds especially located in basal ganglia of human brain. Regardless of the location of microbleeds, we understood that WMH was considerably correlated with microbleeds. Conclusion: A higher prevalence of microbleeds was proved in the Korean ischemic stroke patients than Caucasians. Also, we found that male or WMHs might be the risk factors for microbleeds. Furthermore, hypertension was a risk factor of the microbleeds existed in basal ganglia. WMHs were one of the most important risk factors for microbleeds in spite of bleeding site. doi:10.1016/j.jns.2013.07.704
Abstract — WCN 2013 No: 621 Topic: 3 — Stroke Clinical characteristics of stroke patients in the Northern Thailand S. Kosachunhanuna, N. Tipayajakb, A. Khunkumb. aNeurology, Chiang Mai Neurological Hospital, Chiang Mai, Thailand; bResearch Unit, Chiang Mai Neurological Hospital, Chiang Mai, Thailand Background: Acute stroke required emergency management. Objective: This study aimed to analyze the clinical characteristics and management of stroke in the Northern Thailand. Material and methods: We interviewed patient/relative and analyzed the data of the acute stroke patients admitted to twelve government hospitals in the Northern Thailand during October 2010 to September 2012. Results: Total of 802 acute stroke patients were recruited, mean age was 65 ± 13.5 years old, 54.1% were female. Most patients had regularly exercise and rarely consumed alcohol. Co-morbidities such as hypertension, diabetes, dyslipidemia were 57.2%, 15.6%, 18.4% respectively. Ischemic and hemorrhagic strokes were 79.7% and 20.3%, respectively. Clinical characteristics of the patients including BP, pulse, GCS, NIHSS, and blood tests were not different between ischemic and hemorrhagic strokes. Patients admitted to general ward were 73% and only 13.1% were admitted to stroke unit. Thrombolytic agent was given in 10.4% of the ischemic stroke patient. The reasons that this agent was not used were unavailable in the hospital for 24.5%, and 75.5% had contraindications including delayed onset
Background: Despite extensive investigations in the stroke medicine, still there is little known about the course of spontaneous intracerebral haemorrhage (SICH) in the very elderly. Material and methods: A retrospective study of 231 consecutive cases diagnosed with SICH was carried out in the Department of Neurology at the Medical University of Warsaw. A case control study included patients with SICH aged ≥80 years. Data on risk factors, clinical presentation, neuroimaging and outcomes were collected and statistically analysed. Results: The whole studied population consisted of 231 patients (52%male): 66 aged ≥80 years and 165 b 80 years of age. There were more female cases among the very elderly (65% vs 46%, p = 0.009). Hypertension was the most common risk factor in both age groups (p = 0.21). Coronary artery disease and atrial fibrillation were statistically more frequent in the elderly (CAD:p b 0.001; AF:p b 0.001). No significant differences were observed in GCS score or the SICH site. Larger hematoma size (3.6 cm vs 3.2 cm, p = 0.04) and more frequent occurrence of intraventricular extension (IVH) (41% vs 24%, p = 0.05) were found in patients aged ≥80 years. The mortality rate was higher in the older patients (in-hospital mortality: 40.9% vs 15.2%, 30-day mortality: 33.3% and 13.3%; both p = 0.02). Hematoma size predicted in-hospital case fatality in the very elderly (p = 0.005), whereas hematoma size and GCS score had predictive value in patients aged b80 years (p = 0.001 and p = 0.017, respectively). Conclusion: The very elderly patients with SICH are a high risk group as far as clinical outcomes and prognosis is concerned. Hematoma size seems to be the most powerful parameter in predicting early mortality. Further prospective studies are needed to identify prognostic factors in this subpopulation. doi:10.1016/j.jns.2013.07.699
Abstract — WCN 2013 No: 605 Topic: 3 — Stroke Prevalence and radiological peculiarities of metabolic syndrome and hypertension in stroke patients M. Kapianidze, M. Janelidze, N. Mikava, N. Kvirkvelia, N. Lobjanidze, S. Kapianidze, N. Akiashvili, T. Maisuradze. Neurology, S. Khechinashvili Medical University Hospital, Tbilisi, Georgia Background and purpose: Hypertension, obesity and diabetes (metabolic syndrome) are significant risk factors of stroke. A better understanding of relation between metabolic syndrome and hypertension may lead to the reduction of cerebrovascular risks and improve the stroke treatment and outcome as well. Methods: A total of 345 (F = 198, 69.7 ± 5.3) patients with acute stroke were investigated. Diagnosis of Metabolic syndrome (MetS) was ascertained according to the revised National Cholesterol Education Program Adult Treatment Panel III (ATP III-r). Stroke was diagnosed using NIHSS criteria. Type, side and site of stroke were assessed by MRI. Hypertension (HYP) was defined according to cardiovascular criteria, based on target organ damage. In addition to hypertension, other modifiable and non-modifiable risk factors were recorded. Neuropsychological battery and MMSE tests were performed in the target population. The data statistically evaluated by SPSS-11.0. Results: Among stroke patients 124/35.9% found to have MetS, 106/ 85.4% diagnosed as ischemic stroke with lacunar or multiple brain lesions. Most of the patients with female preponderance (76) had moderate to severe leucoaraiosis (71%), mild-to moderate cognitive disturbances (54%) and dementia (14%). The HYP and obesity alone146/42.3% patients had more haemorrhagic stroke (79/54.1%) with male dominance and psychological disturbances, such as depression (46%) or depression-anxiety disorders (31%).
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Conclusions: Mets may be considered as independent risk factor for ischemia and dementia (P N 0.001), while the Hypertension and obesity alone may carry the risk of bleeding and neuropsychological disturbances (P N 0.001). doi:10.1016/j.jns.2013.07.700
Abstract — WCN 2013 No: 607 Topic: 3 — Stroke Comparison of comorbidity of hypertension and mild cognitive impairment in atrial fibrilation's patients after stroke and miocardial infarction M. Kapianidze, N. Akiashvili, M. Janelidze, S. Kapianidze, N. Kvirkvelia, N. Lobjanidze, T. Maisuradze, N. Mikava. Neurology, S. Khechinashvili Medical University Hospital, Tbilisi, Georgia Background: Mild Cognitive Impairment is the frequent sequela of patients with neurovascular and cardiovascular disorders, especially patients with Atrial Fibrilation and may lead to vascular dementia. Aim: The aim of the study was to establish the role Hypertension on development of MCI after stroke and Miocardial Infarction. Methods: 192(93/99) poststroke and post-MI patients with AF were investigated and underwent MRI scan. Cognition and daily activity evaluated by MMSE, ADL Index, Cognitive function investigated by neuropsychological battery test and acute phase and after 3 months. Depression was evaluated by Hamilton Depression Rating Scale. According to the test data both neurological (after Stroke) and cardiovascular (after Miocardial Infarction) patients with atrial fibrilation were separately divided in III groups: I — MCI alone, II — Hypertension alone, III — MCI + Hypertension. Groups did not differ due to vascular risk-factors and demographic variables. Results: From patients with MI–MCI and Hypertension alone was diagnosed in 56 (56.5%) and 38 (38.3%), but after Stroke in 42 (45.1%) and 76 (81.7%) cases respectively. Hypertension + MCI — were revealed after MI in 42 (42.2%) and postStroke in 68 (71.1%) cases, — Comparision of both groups revealed that Hypertension +MCI and Hypertension alone have more frequently were in poststroke group as well as ADL Index and MMSE, but depression alone 58 (58.5%) and Executive Dysfunction Syndrome alone 63 (63.6%) more frequently as well their comorbidity (34/34.3%) in cardiac patients vs poststroke. (p b 0.05).which were correlated with multiple lacunar silent damage radiologically. Conclusion: In AF-poststroke patients more demented and hypertensive (OR 9.90, P = 0.031), but the AF-MI patients have more frequently mild cognitive decline and depression (OR 8,9, P N0.001). doi:10.1016/j.jns.2013.07.701
Abstract — WCN 2013 No: 619 Topic: 3 — Stroke Tracking of mesenchymal stem cells labeled with Gd-Dtpa by Mr imaging in cerebral ischemia model K. Genga, D.X. Huanga, R.H. Wub. aShantou University Medical College, 2nd Affiliated Hospital of Shantou University Medical College, Shantou, China; bDepartment of Medical Imaging, 2nd Affiliated Hospital of Shantou University Medical College, Shantou, China Objective: Recent developments in stem cell and gene therapy will require methods to monitor stem cell survival and integration repeatedly and non-invasively with a high temporal and spatial
e170
Abstracts / Journal of the Neurological Sciences 333 (2013) e152–e214
resolution in vivo. The aim of the study was to explore the possibility of the rat mesenchymal stem cells (MSCs) labeled with standard contrast agents (Gd-DTPA) for stem cell tracking. Methods: MSCs from bilateral femur of rats were cultured and propagated. Intracellular uptake of Gd-DTPA was achieved by using a non-liposomal lipid transfection reagent (Effectene) as the transfection agent. Electron microscopy was performed to detect the distribution of Gd-DTPA particles in MSCs, and labeling efficiency of Gd-DTPA particles on MSCs was evaluated using spectrophotometric. Viability and proliferation of labeled MSCs were evaluated using MTT assay. Labeled MSCs were detected with T1-weighed MR imaging in vitro and in rat brain. Results: The presence of Gd-DTPA particles inside the MSCs was definitely detected by transmission electron microscopy. Labeling efficiency was highly. There was no difference in viability and proliferation between the labeled and unlabeled confirmed by MTT values of light absorption. The labeled MSCs demonstrated the high signal intensity on T1-weighted MRI in vitro and in rat brain. Conclusion: Rat MSCs can be labeled with Gd-DTPA particles without changing the cell viability and proliferation. Obviously labeled MSCs can be imaged in vitro and vivo. Gd-DTPA shows no evident adverse effect on the function of labeled MSCs. Gd-DTPA can be used for the MR imaging tracking of labeled MSCs. doi:10.1016/j.jns.2013.07.702
Abstract — WCN 2013 No: 637 Topic: 3 — Stroke Epidemiology of stroke risk factors in Belarus H. Lushchyk, S. Likhachev. Neurological Department, State Institution ‘Republic Scientific Practical Centre of Neurology and Neurosurgery’, Minsk, Belarus Background: Stroke is one of the leading causes of death. Death from stroke in people of working age is particularly alarming. Studying the prevalence of stroke risk factors will help develop an optimal system for prophylaxis thus reducing morbidity and mortality from stroke. Objective: The aim of the study was to study prevalence of stroke risk factors among people of working age. Patients and methods: Using a specially developed standardized questionnaire card we carried out the screening of open population. We examined 189 people aged between 40 and 62 years (mean age 51.68 years) of one of the district polyclinics in Minsk, including 135 women (71.43%) and 54 men (28.57%). Results: The following risk factors were revealed: · Overweight — 128 people (67.72%), including 66 people with a BMI of 26–29 (34.92%) and 62 people with a BMI ≥30 (32.8%); · Arterial hypertension — 87 people (46.03%), including 33 people with hypertensive crisis in medical history; · Family history of hypertension before the age of 60 years — 98 people (51.85%); · Hypodynamia — 71 people (37.57%); · Smoking — 46 people (24.34%); · Coronary heart disease — 35 people (18.52%); · Family history of stroke/heart attack before the age of 60 years — 31 people (16.4%); · Diabetes mellitus — 11 people (5.82%); · Alcohol abuse — 7 people (3.7%). Conclusion: The most common stroke risk factors in the studied population are overweight, hypertension and hypodynamia. Particularly disturbing is the fact that only 44 people (50.57%) with hypertension regularly take antihypertensive medication. doi:10.1016/j.jns.2013.07.703
Abstract — WCN 2013 No: 470 Topic: 3 — Stroke The prevalence and association with cerebrovascular risk factors of cerebral microbleeds in Korean ischemic stroke patients E.J. Choi, T.-W. Kim, J.-S. Kim. Neurology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea Background and Purpose: Advanced age, presence of intracerebral hemorrhage or ischemic stroke, dementia, hypertension, and use of antithrombotic therapy have been reported to be associated with a higher risk of cerebral microbleeds. In addition, the severity of white matter hyperintensity (WMH) was known to be associated with cerebral microbleeds. We tried to investigate the frequency and the number of mirobleeds in Korean ischemic stroke patients and risk factors as well as their relationship to microbleeds. Methods: Four hundred subjects (mean age ± SD: 66.5 ± 13.5) visited for acute cerebral infarctions or transient ischemic attacks were enrolled in this study. For each subject, we researched the baseline demographic characteristics, cerebrovascular risk factors, the number and localization of the microbleeds or WMHs. Results: The prevalence of mirobleeds in this study was 31%. We revealed that male gender, history of heart disease and WMH acted as burdens of microbleeds. After regional subdivision, hypertension was a risk factor for microbleeds especially located in basal ganglia of human brain. Regardless of the location of microbleeds, we understood that WMH was considerably correlated with microbleeds. Conclusion: A higher prevalence of microbleeds was proved in the Korean ischemic stroke patients than Caucasians. Also, we found that male or WMHs might be the risk factors for microbleeds. Furthermore, hypertension was a risk factor of the microbleeds existed in basal ganglia. WMHs were one of the most important risk factors for microbleeds in spite of bleeding site. doi:10.1016/j.jns.2013.07.704
Abstract — WCN 2013 No: 621 Topic: 3 — Stroke Clinical characteristics of stroke patients in the Northern Thailand S. Kosachunhanuna, N. Tipayajakb, A. Khunkumb. aNeurology, Chiang Mai Neurological Hospital, Chiang Mai, Thailand; bResearch Unit, Chiang Mai Neurological Hospital, Chiang Mai, Thailand Background: Acute stroke required emergency management. Objective: This study aimed to analyze the clinical characteristics and management of stroke in the Northern Thailand. Material and methods: We interviewed patient/relative and analyzed the data of the acute stroke patients admitted to twelve government hospitals in the Northern Thailand during October 2010 to September 2012. Results: Total of 802 acute stroke patients were recruited, mean age was 65 ± 13.5 years old, 54.1% were female. Most patients had regularly exercise and rarely consumed alcohol. Co-morbidities such as hypertension, diabetes, dyslipidemia were 57.2%, 15.6%, 18.4% respectively. Ischemic and hemorrhagic strokes were 79.7% and 20.3%, respectively. Clinical characteristics of the patients including BP, pulse, GCS, NIHSS, and blood tests were not different between ischemic and hemorrhagic strokes. Patients admitted to general ward were 73% and only 13.1% were admitted to stroke unit. Thrombolytic agent was given in 10.4% of the ischemic stroke patient. The reasons that this agent was not used were unavailable in the hospital for 24.5%, and 75.5% had contraindications including delayed onset