الفهرس 
EpidimiologyOnly 14 pages are availabe for public view
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Abstract
Summary and Conclusion
Stroke is the third leading cause of death in women. The
burden of stroke in women was often underestimated whereas it
is a major public health problem for women. Gender differences
do exist in risk factor profile, stroke presentation, severity,
radiological characteristics, choice and response to therapy.
These gender differences in risk profile should influence risk
stratification and treatment. Also In this work, there is data that
support the development of woman-specific stroke risk profiles,
which might more accurately reflect a woman’s future risk of
stroke than some of the currently available stroke risk profiles.
In addition, current evidence for prevention was summarized
focused on the risk factors that are either unique to or more
common in women than men.
The aim of this work is to identify the characteristics of
acute stroke in a sample of Egyptian women with specific
emphasis on etiology, risk factors, clinical picture, type, site
and size of stroke.
This was conducted through a cross sectional study done
on 103 female patients with acute stroke admitted to stroke unit
stroke unit & neurology department at Ain Shams University
hospitals within first 48 hours of stroke onset over one year.
Patients were subjected to: 1. General history and
examination. 2. Neurological history and examination including
NIHSS score (national institute of health stroke scale) for
assessment of clinical severity. 3. Laboratory investigations
Summary & Conclusion
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including full laboratory investigations including complete
blood count, lipid profile, liver & kidney functions, serum
albumin, coagulation profile. 4. Neuroimaging in the form of
MRI brain and MRA of cerebral arteries were done within 48
hours of onset. 6. ECG & transthoracic echocardiography &
Carotid duplex.
The study results showed that the age of the patients in the
study population was within the age group of susceptible
population in Egypt, Among these patients the most prevalent
risk factors were hypertension, positive family history, diabetes
mellitus, followed by significant cardiac disease, previous
cerebral vascular insults, and then dyslipidemia and lastly
patients who had history of collagen disease, smoking and
patients with thrombophilia. There were 22.3% of patients with
previous cerebral insults Including CVS, TIA, sinus
thrombosis, intracranial Hemorrhage with 14.6% of patients
with more than one insult. Previous silent infarts was reported
in 20.4% patients. 38.8 % of patients had a significant cardiac
disease with the most prevelant is ischemic heart diseases,
followed by rheumatic heart disease and then AF. 7 patients
(6.8 %) had significant extra cranial carotid arteries stenosis
greater than 50% reported by carotid duplex examination.
Higher NIHSS score on admision was associated with higer
serum LDL cholesterol and ESR. 91% of patients had ischemic
stroke and 1.9% of patients had intracranial hemorrhage. Also
there were 3.9% of patients had sinus thrombosis lesion, 2.9%
had TIA. 48.5% patients had lesions on the right side while
41.7% patients had lesion on the left side while 6% patients had
bilateral lesions. Ischemic stroke is a polyetiologic disease with
Summary & Conclusion
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marked differences between subtypes regarding risk factors and
outcome. Large artery disease was more prevalent than other
types of acute ischemic stroke in our patients followed by patients
with small artery disease, and then cardioembolic strokes. Also
Partial anterior circulation strokes (PAC) was more prevalent
than other types of acute ischemic stroke in our population
followed by Lacunar strokes then Posterior circulation strokes
(POC) and Total anterior circulation strokes (TAC). Higher
NIHSS score both on admision was associated with Total
anterior circulation strokes (TAC) then Posterior circulation
strokes (POC) then Partial anterior circulation strokes (PAC)
and lastly Lacunar strokes. Higher number of risk factors were
associated with a lager size of the infarcts with 42.8% of
patients who had large infarction among study patients occur in
patients who had 4 or more risk factors. Large infarcts had
higher NIHSS score compared to small and very small infarcts.
14 patients (13.6%) was found to have cardioembolic stroke, all
of them were significantly older than those who suffered from
other types of infarction, with the most prevelant risk factors
were having valve lesion & dialted LAD, Most of the
cardioembolic patients 64.3% had partial anterior circulation
strokes (PAC). left predominance was reported in
cardioembolic strokes. Diffuse atherosclerosis is the main
pathology of intracranial vessels followed by stenosis of main
vessel and then occlusion of main stem vessel. Stenosis or
occlusion of intracranial vessels. MCA was the most common
intracranial vessel reported with stenosis or occlusion followed
by ACA and PCA and then vertebral, ICA and basilar.