The Study of Stroke due to intra cranial atherosclerosis in Population of Bihar

  • Deepak KarnAssistant Professor and Head of the Department Neurosurgery Shri krishna Medical College and Hospital Muzaffarpur-842001, Bihar
Keywords: MRA, HTN, DM, Homocystine, recurrence


Background: Ischemic stroke is quite heterogeneous in its patho-physiological mechanism associated with atherosclerosis. Little is known about measures for prevention of the disease apart from latest technologies and medications.

Method: 100 patients of different age groups were studied with MRA, to rule out occlusion or lesion; tropical distribution of infarction, clinical manifestations, recurrence after treatment was also noted.

Results: Clinical manifestations included 33% alcoholic, 21% homocystine, 80% HTN, 54% DM, 30% Hyper-lipidemia, 35% smoking, 48% HTN + DM, 17% HTN + DM +Hyper-lipidemia, 7% HTN + DM + Hyper-lipidemia, + smoking + Alcohol. Highest occlusion was observed 51 (39.9%) in MCA followed by 20 (14.4%) ICA, 23 (16.6%) BA, 18 (13.04%) VA and least was 2 (1.4%) in VA+BA. Highest tropical distribution of infarction was 28% cortical followed by 24% sub cortical and cortical, 23% cortical, 11% cerebellum, 8% Brainstem and recurrence was observed in 19% patients.

Conclusion: The present pragmatic study will help for efficient management and risk control for Neuro-physician and neurosurgeon because risk factor control remains the best strategy for preventing recurrence because recurrence of the stroke worsen the physical and mental conditions of the patients.


1. Sacco RL, Karryman DE – Race ethnicity and determinants of intra cranial atherosclerotic cerebral infarction stroke 1995, 26; 14-20.
2. White H, Boden, Albala – Ischemic stroke sub-type incidence among whites, blacks and Hispanics the northern Manhattan study. Circulation 2005, 111; 1327-1331.
3. Wity K RJ, Lehman D – A Race and sex difference in distribution of cerebral atherosclerosis. Stroke 1996, 27; 1974-1980.
4. Bang OY, Kim JW, Lee JH – Association of metabolic syndrome with intra cranial atherosclerotic stroke, Neurology 2005, 65; 296-298.
5. Wang LK – global burden of intracranial atherosclerosis Int. J, of stroke 2006, vol. 11(3); 158-159.
6. Caplan LR, Goerelick and Hier – Race, Sex and occlusive cerebro-vascular disease review stroke 1986, vol. 17 (4); 648-655.
7. Nishimaru IC, McHenry Jr. – Cerebral angiographic and clinical differences in carotid system transient ischemic attacks between American Caucasian and Japanese patients stroke 1984, 15(1); 56-59.
8. Liebeskind DS, Costsonis GA – warfarin, Aspirin symptomatic intracranial disease (WASID) investigators collaterals dramatically alter stroke risk in intracranial atherosclerosis Ann. Neurol 2011, 69; 963-71.
9. Joshi R, Cardana M, Iyengar S – Chronic diseases now a leading cause of death in rural India – Mortality data from Andhra Pradesh rural health initiative Int. J. Epidemiol. 2006, 35; 1522-9.
10. Prasad K, Singhal KK – Stroke in young; An Indian Perspective. Neurol India 2010, 58; 343-50.
11. Ghosh P, Mishra AK, Bhattacharya AK – The effect of tea in cardio-vascular disease Ethno-Med. 2012, 6; 161-6