International Journal of Research in Medical Sciences | October-December 2014 | Vol 2 | Issue 4 Page 1355
International Journal of Research in Medical Sciences
Kapoor D et al. Int J Res Med Sci. 2014 Nov;2(4):1355-1359
www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012
Research Article
Clinical profile, risk factors and aetiology of young stroke:
a tertiary care hospital based study from the
Sub-Himalayan region in North India
Dhiraj Kapoor*, Ashish Dhiman, Rupinder Sharma, Shyam Sundar
INTRODUCTION
Stroke is one of the leading causes of mortality and
morbidity worldwide. Urbanization is predicted to
increase the risk factors for vascular disease and hence
lead to a sharp increase in stroke.
Ability to forecast stroke is critical but has been
challenging, making the detailed study of predisposing
factors essential. Prevention still holds the key to reduce
the impact of stroke. For planning prevention strategies,
reliable information on profile of diseases, in defined
populations, is necessary.
Younger patients with stroke account for 5-10% of all the
stroke worldwide. The impact of stroke on the individual
family and society is strongest when it affects a young
individual.
Himachal Pradesh is situated in the north-west of India in
Sub-Himalayan region. The only data available about
stroke in young is from Kashmir by Kaul et al.
1
undertaken in 1989 which was a community based study.
ABSTRACT
Background: Rapid urbanisation of rural areas is predicted to increase the incidence of risk factors for vascular
events like stroke. There is scarcity of literature addressing issue of stroke from Sub-Himalayan region in North India.
Methods: The study was conducted in the department of medicine, R. P. govt. medical college, Kangra, Himachal
Pradesh. Consecutive patients between the age of 15-45 years presenting with signs and symptoms of stroke in a
duration of one year were included in the study. CT scan-head and lipid profile was done in all patients. Other
relevant investigations to rule out aetiology were undertaken.
Results: Thirty two patients with the mean age of 41.1 ± 5.41 years were recruited. The incidence of stroke in young
forming 8.55% of the total stroke patients (374). There were larger proportion of male patients with a ratio of 3:1.16
patients (50%) presented between 6 am and 12 pm in the morning hours of day. Maximum patients presented in
winter months from November to January. Average delay of presentation to hospital was 30.8 hours. 19 patients
(59.3%) presented with infarct. Most common symptom reported was weakness in 18 (56.2%). Predominant
traditional risk factors observed was hypertension in 18 (53.1%). Hyperhomocysteinemia was seen in 4 patients
(12.5%). Primary antiphospholipid antibody syndrome was seen in 2 (6.25%).
Conclusion: This study demonstrated predominant presence of conventional risk factors in young strokes. There was
substantial time delay of presentation. Majority of patients presented in winter months. Prevention of vascular risk
factors as well as issue of factors leading to delay in presentation needs to be addressed.
Keywords: Young stroke, Sub-Himalayan, Risk factors
Department of Medicine, R. P. Govt. Medical College, Tanda, Kangra-176001, H.P., India
Received: 20 July 2014
Accepted: 10 August 2014
*Correspondence:
Dr. Dhiraj Kapoor,
E-mail: kapoordhiraj65@rediffmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: 10.5455/2320-6012.ijrms20141121