Risk factors related to familial hemorrhagic stroke

Stroke is the fourth leading cause of death in the United States and is a leading cause of long-term disability. More than 795,000 people have a stroke annually. Ischemic strokes account for 87% of all strokes, and hemorrhagic strokes account for 13% of all strokes. Although family history is an indicator for both types of stroke, ischemic strokes are more closely related to environmental risk factors, such as diet, exercise and smoking. Hemorrhagic strokes also aggregate within families but often occur at younger ages indicating a possible genetic link. The purpose of this study was to identify similarities and differences of the biological risk factors associated with hemorrhagic stroke, such as hypertension, diabetes mellitus and/or high cholesterol, and environmental risk factors, such as exercise, alcohol consumption, smoking, and perceived stress within and between families with a history of hemorrhagic stroke. Methods: 14 individuals (8 with hemorrhagic stroke, 6 without hemorrhagic stroke) participated from 4 families with a family history of hemorrhagic stroke were recruited from stroke support groups in the southeast, social media and Casa Colina Hospital and Medical Center in Pomona, California. Participants completed medical and family history questionnaires, as well as, the Health Promoting Lifestyle Profile (HPLPII) and the Perceived Stress Scale (PSS). Results: Nonparametric statistical analysis and visual representation were utilized to compare biological risk factors associated with hemorrhagic stroke within and between families and to measure the strength and direction of association that exists between groups. Hypertension was the most salient biological risk factor among all study participants (87%), followed by high cholesterol (42.9%) and diabetes mellitus (14.3%). General stress and alcohol consumption was reported in all families (50% and 57% of participants, respectively). Mann-Whitney U Test indicated that PSS scores were significantly higher for participants with hemorrhagic stroke (=24.33) than for participants without hemorrhagic stroke (=15.67), U=4.0, p=.028). Conclusion: There is not one clear biological or environmental factor identified as the cause of familial hemorrhagic stroke; however, hypertension seems aggregate within families with a history of hemorrhagic stroke suggesting that it may be a major risk factor. In addition, perceived stress was significantly higher in participants with hemorrhagic stroke compared to those without hemorrhagic stroke suggesting that it is also a risk factor for familial hemorrhagic stroke

Epidemiology of stroke patients in Tikur Anbessa Specialized Hospital: Emphasizing clinical characteristics of Hemorrhagic Stroke Patients

Background: Stroke is one of the leading causes of death and adult disability. Unlike the developed world, hemorrhagic stroke has been reported to be more prevalent in sub-Saharan Africa. Risk factors and determinants of stroke are not well identified in Ethiopia.Methods: A retrospective chart review of all stroke patients who presented from December 2010 to December 2014 was conducted. Demographic characteristics, risk factors and stroke types and their hospital outcome were reviewed, emphasizing on hemorrhagic stroke patients.Result: During the study period, 301 patients were seen for stroke, of which a total of 139(46.1%) were hemorrhagic stroke patients. From the hemorrhagic stroke patients, 88 (63.3%) of them were male and 51 patients (36.7%) were female. From those hemorrhagic stroke patients, 103 patients (74.1%) of them had hypertension. Majority, 65(63.1%), of hypertensive hemorrhagic stroke patients were not adherent to their antihypertensive medication. From hemorrhagic stroke patients with HTN, 28(27%) of them were diagnosed to have HTN after stroke already occurred. From the study participants, 58(19.2%) of the patients died in the hospital and 35 (60.3%) of them were hemorrhagic stroke.Conclusion: The proportion of hemorrhagic stroke is higher compared with other developed countries. Untreated hypertension may be the contributing factor. Early detection of hypertension and strict control, early health seeking, and good comprehensive stroke care will potentially decrease the mortality and morbidity of stroke.Key words: Stroke, Hemorrhagic, Hypertension, non-complianc

Clinical profile of acute hemorrhagic stroke patients: a study in tertiary care hospital in Northern India

Background: Acute hemorrhagic stroke, a subtype of acute stroke is one of the leading cause of death and major cause of morbidity and mortality throughout the world. The incidence of acute hemorrhagic stroke is increasing with gradual increase in obesity, diabetes mellitus, hyperlipidemia, hypertension and various cardiac problems. This study had been conducted with an objective to study the risk factors and clinical presentation of acute hemorrhagic stroke patients in north-Indian population. Methods: This study was carried out among 100 acute hemorrhagic stroke patients (clinically and radiologically confirmed) irrespective of age and sex admitted to Emergency Department of KGMU, Lucknow after getting clearance from Institutional Ethical Committee(IEC). These patients had been subjected to plane CT (computed tomography) scan brain on admission by the CT scan model 16 slice Brivo 385 for radiological confirmation and to localize the lesion in brain. Data were collected in prescribed protocol.Results: Majority of the patients were in the (50-60) age group with male predominance. Hypertension (62%) was the most common risk factor for acute hemorrhagic stroke followed by Non-veg diet (46%). The commonest clinical feature at presentation was hemiplegia (76%). Majority (47%) of the patients presented with Glasgow Coma Scale (GCS) of (9-12). Cerebral cortex (41%) was the most common site of brain lesion in acute hemorrhagic stroke patients. Conclusion: This study focuses on the clinical profile and risk factors of acute hemorrhagic stroke, by targeting which the burden of this disabling disease can be prevented.

Hubungan Stres Hiperglikemia dengan Indeks Barthel Pasien Stroke Hemoragik Akut di Bangsal Saraf RSUD Arifin Achmad Provinsi Riau

Stress hyperglycemia is a condition of elevated blood glucose caused by disruption of the blood glucose regulation which is part of the non-specific reaction of stress or tissues damage. Stress hyperglycemia is common in acute diseases such as stroke, which significantly affect patient outcomes assessed with the Barthel Index. The purpose of this study is to find the correlation of stress hyperglycemia with Barhel index in patients with acute hemorrhagic stroke. Using observational analytic method with cross sectional design. The sample of this study are acute hemorrhagic stroke patients totaling 33 persons who confrom the inclusion criterias. Results of the study of 33 patients, found of stress hyperglycemia cases was 21 patients (63.6%) in acute hemorrhagic stroke. The discription of Barthel index in patients with acute hemorrhagic stroke are complete dependence (0-20) of 23 patients (69.69%), 10 patients (30, 30%) with severe dependence (21-61). There is positive correlation with moderate strength between stress hyperglycemia with Barthel Index in patients with acute hemorrhagic stroke (p = 0.001; r-0.513). The Conclusion is prevalence of stress hyperglycemia were 63.6% with the highest distribution of Barthel index is a full dependence totaling 23 patients (69.69%). There is positive correlation with moderate strength between stress hyperglycemia with Barthel Index in patients with acute hemorrhagic stroke (p = 0.001; r-0.513

Perbedaan Kadar Kolesterol Total Antara Penderita Stroke Iskemik dan Stroke Hemoragik di RSUD Dr. Moewardi

Background: Stroke is one of the world's problems that become the third leading cause of death in the world, after heart disease and cancer. Stroke in Indonesia caused the most of death, amounting to 15,4%. Lipid levels is one of the factors that affect short-term morbidity from stroke, so that the differences in the levels of lipids in the evaluation of stroke subtype is very important to do. Based on research conducted by Chaudhury (2014), there were differences in total cholesterol levels significantly between patients with ischemic stroke and hemorrhagic stroke, while according to Dey (2010) there was no difference in total cholesterol levels between patients with ischemic stroke and hemorrhagic stroke. Purpose: to determine whether there are differences in total cholesterol among patients with ischemic stroke and hemorrhagic stroke at Hospital Dr. Moewardi. Methods: The design of this research is analytic observational study with cross sectional approach. Data were retrieved from medical records of patients with ischemic stroke and hemorrhagic stroke that ever hospitalized at Hospital Dr. Moewardi years 2014-2015, who have met the inclusion and exclution criteria. Total sample size was 60 people, consisting of 30 patients with 30 patients with ischemic stroke and hemorrhagic stroke. The data were analyzed with the unpaired t test. Results: Data analysis by unpaired T test showed the results of p=0.005. Total cholesterol levels in patients with ischemic stroke had a mean of 202 ± 33.9 mg / dL, which is higher than the total cholesterol in patients with hemorrhagic stroke which had a mean 167.87 ± 53.6 mg / dL, with a difference of 33.4 mg / dL Conclusions: There are differences in total cholesterol levels among patients with ischemic stroke and hemorrhagic stroke. Total cholesterol levels in patients with ischemic stroke is higher than patients with hemorrhagic strok

Nursing Care for Homeless Patients with Hemorrhagic Stroke at A Public Hospital

A hemorrhagic stroke occurs when a blood vessel in the brain bursts, causing bleeding in the brain tissue. A hemorrhagic stroke can have a significant impact on the patient. Family support has been shown to influence the success of treatment for hemorrhagic stroke patients. Therefore, Family support is substantial and linked to achieving patient independence. Homeless stroke patients typically receive minimal care and have high mortality rates. This paper aims to review the implementation of care for homeless patients with hemorrhagic stroke in a public hospital in Jakarta. This article is a case report of a homeless 65-year-old man with decreased consciousness who was diagnosed with hemorrhagic stroke. The data were obtained by physical assessment. Several diagnostic tests were performed, including CT scan, MRI, and blood tests. A student nurse working one shift per day provided nursing care for three days. The patient had limb paralysis and drowsiness. The priority diagnoses were ineffective cerebral tissue perfusion, impaired physical mobility, and deficits in self-care. Nursing care focuses on the patient's consciousness and fulfilling basic needs. After 3 days of care, the patient was still unconscious. However, there were no symptoms of increased intracranial pressure. Family participation is necessary for the care of patients with hemorrhagic stroke. The nurse's role as a caregiver becomes primary and crucial for homeless patients who have no family

TO STUDY THE SERUM LIPID PROFILE IN ISCHEMIC AND HEMORRHAGIC STROKE AMONG THE PATIENTS IN TERTIARY HEALTH CENTRE

Objectives: To assess, correlate and compare the levels of various parameters of lipid profile in patients with ischemic and hemorrhagic stroke. Methods: The study was conducted as an observational study at the Department of Medicine, People’s Hospital on 100 patients presenting with focal neurological deficit, altered sensorium, or with CT/MRI findings suggestive of stroke during the study duration of 18 months. Based upon the type of stroke, patients were categorized into two groups, i.e. ischemic stroke and hemorrhagic stroke. NCEP-ATP III guidelines were used for estimation of dyslipidemia and association of dyslipidemia was observed with type of stroke. Results: Of 100 cases, ischemic stroke was documented in 74% cases, whereas 26% of patients presented with hemorrhagic stroke. Two groups were comparable in terms of baseline characteristics (p>0.05). Mean total cholesterol levels and total cholesterol and total cholesterol to HDL ratio was significantly higher in ischemic stroke as compared to hemorrhagic stroke (p<0.05). However, mean serum HDL level was significantly lower in patients with ischemic stroke as compared to hemorrhagic stroke (p<0.05). Total cholesterol, and total cholesterol: HDL ratio showed statistically significantly negative correlation with type of stroke and positive correlation was noted between HDL and hemorrhagic stroke. Conclusion: The prevalence of stroke is rising rapidly and the age of presentation of stroke is reducing. Ischemic stroke is the most common type of stroke whereas hemorrhagic stroke is less commonly observed in less than one-third of patients. Dyslipidemia is a significant risk factor for ischemic stroke. Raised Total cholesterol, and total cholesterol: HDL levels and lower HDL levels are independent predictors of ischemic stroke