“A Clinico-Radiological Profile Of Acute Ischaemic Stroke As Pertoast Classification In A Tertiary Care Hospital”

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Dr. Nawal Mahboob Basha, Dr. Mohammed Abdul Kabir, Dr. Syeda Afreen Fatima

Abstract

Background:Stroke is one of the leading causes of death and disability worldwide.1 Stroke was a direct cause of 1 in 6 cardiovascular disease-related fatalities in 20202. Over 87% of strokes are


ischemic strokes, which occurwhen the blood supply to the brain is cut off.3The Trial


Organization 10172 categorization (TOAST) was utilized in Treatment for Acute Stroke to


further  classify  strokes  into  those  resulting  from  cardio  embolism  (CE),  large-artery


atherosclerosis (LAA), small vessel occlusion (SVO), and stroke of unknown etiology.1


OBJECTIVES:

  1. To study the aetio pathogenesis of acute ischemic

  2. To study radiological imageology of various stroke

  3. Classification of ischemic stroke according to TOAST (Trial of ORG 10172 in Acute Stroke Treatment)

  4. To evaluate prognosis, outcome and


MATERIAL & METHODS: Study Design: Hospital-based, cross sectional study. Study area: The study was conducted in the Department of General Medicine,Shadan Institute of Medical Sciences & Hospital, Hyderabad, Telangana from April 2023 to September 2023.Sample size: Study consisted a total of 100 subjects.Sampling Technique: Simple Random technique.Study tools and Data collection procedure:All patients who fulfilled the inclusion criteria and giving a written consent for the study were included in the study. A detailed study of the clinical profile of each patient was done based on pre- designed proforma including history, examination and


investigations.Relevant         investigations      like      blood      glucose,      serum      lipid      profile,


electrocardiography, echocardiogram, carotid Doppler, CT scan brain or MRI brain were done for all the patients. All the results were tabulated and analyzed. Outcome studied with reference to Glasgow coma scale at time of admission with special reference to TOAST classifications.


 


Results: The commonest clinical symptom was motor weakness in (82%) cases and the least common was ataxia and vertigo in 1% cases.The most common clinical sign in our study was


motor weakness in the form of paresis or plegia in 86%          cases     and     least     common     was


cerebellar signs in 4% cases.Hypertension was the commonest associated risk factor in 52%


cases and CAD was the least common associated risk factor in 5% cases.


Conclusion: The Trial of Org 10172 in Acute Stroke Treatment (TOAST) system is the most widely used classification system worldwide. It is the most standard etiological classification system for ischemic stroke. This study has revealed significant dependence of ischemic stroke subtype on the vascular territory of the acutely imaged lesions.

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