الفهرس 
Chapter (1): Cerebro-vascular StrokeOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Accurate and prompt prediction of functional outcome, mortality, and complications in patients with ischemic stroke is essential for patients, families, and clinicians. In this context, rapidly measurable and reliable blood biomarkers may refine clinical decision-making. Several blood biomarkers have shown the potential to predict outcome after ischemic stroke. However, to be useful in clinical routine, blood biomarkers are expected to improve the prognostic accuracy of established clinical variables such as stroke severity and age. The current study was carried to search for any correlation between serum copeptin in the first day of ischemic stroke and its clinical severity, radiological findings and also its predictive value of functional outcome and mortality in ischemic stroke patients. It was conducted on 55 patients presenting with acute ischemic stroke attending the Neurology Unit of Neuro-psychiatric department, Faculty of medicine, Minoufiya University. They were 17 females and 38 males. The included patents were subjected to: full history taking, general examination, complete neurological examination, laboratory work up (serum copeptin level in the first 24 hours, routine laboratory investigations for aetiology of CVS). They were also subjected to radiological imaging using CT brain And / Or MRI brain. The clinical severity of stroke was assessed with national institute of health stroke scale at admission and the stroke was classified according OCSP and TOAST classification. The severity of stroke was assessed 3 months later using modified rank in scale. Favourable outcome was defined as MRS (0-2) while unfavourable outcome was defined as MRS (3-6). This study showed that serum copeptin level was higher in patient with severe ischemic stroke on admission. Its level was positively correlated with score of NIHSS scale. Also the level of serum copeptin positively correlated with stroke outcome and mortality. The cutoff point of serum copeptin for un favourable outcome was 21.5 and the cutoff point of mortality was 31. Serum copeptin level increases with increased size of cerebral infarction more than 3cm. Also it increase in large vessel ischemic stroke and stroke of total anterior circulation. Copeptin may be considered reliable prognostic marker in stroke patients and early measurement of serum copeptin could provide better prognostic information for patients with acute ischemic stroke.