Background Stroke is a major leading global health complication. Identification and management of risk factors associated with stroke can help in prior detection, prevention, and improvement in patient care. Purpose To investigate the prevalence of hyperhomocysteinemia (HHcy) and Vitamins B6, B12, and folate deficiency in stroke patients and also to assess other risk factors associated with ischemic and hemorrhagic stroke. Methods Detail history of all the subjects in the study including history of hypertension, anemia, fasting glucose, carotid artery thickness, smoking, alcohol, and dietary intake was recorded. Standard assays for homocysteine (Hcy), Vitamins B6, B12, and folate estimation were done. Lipid and renal profile tests were also performed. The prevalence and odds of having HHcy, Vitamins B6, B12, and folate deficiency, and other risk factors in ischemic and hemorrhagic stroke patients were evaluated. Student’s t-tests and chi-square tests were done for statistical validation of the data. Results Prevalence of HHcy and Vitamins B6, B12, and folate deficiency was not observed in ischemic cases. HHcy and folate deficiency was found to be prevalent in hemorrhagic stroke patients. The odds that a person with HHcy and folate deficiency has hemorrhagic stroke was found to be significantly high. Conclusion In our study, high Hcy and low folate levels emerged as risk factors for hemorrhagic stroke.

Idiopathic intracranial hypertension (IIH) is a condition of unknown etiology and is characterized by elevated intracranial pressure. In this case series we describe the clinical features and responses to treatment of patients presented with IIH. It is a retrospective study of four patients who were presented in our hospital between August 2020 and December 2021 and all patients ethnically belonged to northeast India. The patients were evaluated and diagnosed based on history, physical examination, imaging as well as modied Dandy criteria. Low doses of acetazolamide were recommended for all the patients. Timely diagnosis and accurate treatment of IIH is of utmost importance to avoid any irreversible visual loss.

Objective: Reports on the inverse relation between onset-to-door (OTD) and door-to-needle (DTN) in stroke thrombolysis have been repeatedly reported. The current study aimed to explore the association between DTN with the outcome and multi-component interventions inuencing DTN to understand better why some patients get IVT in >60 mins DTN time. Methods: Twenty-ve consecutive AIS patients treated with rt-PA in the Department of Neurology from January 2019 to December 2022 admitted to our tertiary care hospital were included in this analysis. The patients were grouped into a delay group (door-to-needle time (DTN) > 60 minutes; n=11) or a non-delay group (DTN time< 60 minutes; n= 14). The baseline data, laboratory tests, onset-to-door (OTD) time, door-to-imaging time (DTI), and decision-making time in both groups were retrieved. Multivariate logistic analysis was performed to analyze the data. Results: There were signicant differences in hypertension, coronary artery disease, admission National Institutes of Health Stroke Scale (NIHSS), the Door to Imaging (DCT), Door to Needle (DTN), and decision-making time (DMT) between the two groups (all P<0.05). Multivariate logistic regression analysis revealed that the in-hospital delay was closely related to mRS score, OTD time, DCTtime, DMT, and hypertension (p<0.001). Conclusion:The study reects that the lesser the door-to-needle time and the sooner the treatment of thrombolysis to stroke patients, the better the clinical outcomes and recovery of the patients

Background Stroke is the fourth leading cause of death in India. Data on long-term outcomes of patients with stroke in India are relatively sparse. Objective To document survival and long-term functional outcomes of patients with acute stroke and to assess the measures taken for secondary prevention of stroke. Methods and Material A five-year retrospective cohort study involving 118 patients with acute stroke was conducted. Details about five years’ survival, functional outcomes (modified Rankin Scale [mRS], Barthel index [BI], and Hamilton Depression Rating Scale [HDRS]), and secondary prevention measures were investigated. Results Among the patients, 38.1% were diagnosed with ischemic stroke and 61.8% were diagnosed with hemorrhagic stroke. Hypertension was observed to be the predominant risk factor in a majority of the admitted patients. About 30.5% of patients died in the hospital within zero to four weeks after the index event, while 27.1% died during the follow-up period of five years. Approximately 21.1% of patients experienced a recurrent stroke over the next five years which turned out fatal. The quality of life was seriously affected in 32.4% of survivors. It was seen that 40.5% of survivors were fully independent and 45.9% were able to return to their occupation after five years poststroke. Prevalence of severe and very severe depression was observed in 3.4% and 1.7% of survivors, respectively. The majority of the survivors (93.9%) were aware of the risk of recurrent stroke. Physical activities as measures for the prevention of stroke were undertaken by 60.6% of survivors. Conclusion Effective strategies for secondary prevention and also for long-term survival after stroke should be initiated as early as possible after the onset of the initial stroke. Stroke survivors should be closely monitored for their functional recovery and behavioral and emotional improvement poststroke.