الفهرس | Only 14 pages are availabe for public view |
Abstract C.T brain was done for all patients; hemorrhagic cases were excluded after C.T brain. Follow up C.T brain, 72 hours later was done for patients whose C.T brain did not detect any abnormality. MRI brain was done for patients whose first and follow up C.T did not detect the lacunar infarction. Carotid and vertebrobasilar duplex was done for all patients. Echocardiography and ECG were done for all patients while transesophageal Echo was don for patients younger than 40 years and patients without obvious risk factors. Laboratory investigations including fasting blood sugar (FBS), 2 hours post prandial blood sugar (PPBS), complete blood count (CBC), lipid profile including blood cholesterol and serum triglycerides and serum uric acid were done for all patients. Homocysteine, protein C, S and anticardiolipin antibodies, ANA, ANCA and anti DNA were done for patients younger than 40 years and patients without obvious risk factors. This study found out the following: Age and sex were not specific risk factors for either lacunar or non lacunar ischemic strokes. Family history of previous stroke was a specific risk factor for lacunar strokes Previous stroke (recurrence) is a specific risk factor for lacunar strokes. Hypertriglyceridemia was a specific risk factor for lacunar stroke While hypercholesterolemia was not specific risk factors for either stroke group. Cardiac diseases are specific risk factor for non lacunar strokes. On the other hand history of migraine was a risk factor in females in non lacunar stroke group. Significant carotid stenosis (>50%) was mush more common among males in non lacunar stroke group. Hypertension, D.M and smoking were not specific risk factors for either lacunar or non lacunar strokes, while these factors were risky for recurrence in lacunar stroke group. More than 60 % of all patients in both stroke groups were lacking regular physical exercise. Hypertriglyceridemia was a specific risk factor for lacunar stroke While hypercholesterolemia was not specific risk factors for either stroke group. Cardiac diseases are specific risk factor for non lacunar strokes. On the other hand history of migraine was a risk factor in females in non lacunar stroke group. Significant carotid stenosis (>50%) was mush more common among males in non lacunar stroke group. Hypertension, D.M and smoking were not specific risk factors for either lacunar or non lacunar strokes, while these factors were risky for recurrence in lacunar stroke group. More than 60 % of all patients in both stroke groups were lacking regular physical exercise. RECOMMENDATION - Further studies to detect if there is specific association between certain risk factors and each type of lacunar syndromes. 2-Further studies to compare risk factors of first lacunar and recurrent lacunar strokes. 3-All population at risk of developing ischemic stroke should be advised by physicians for regular exercise at least walking 30 minutes every day. 4-Extended study with larger number of patients is recommended. |