Background: Nationally, information regarding risk factors for early and late recurrence of ischemic stroke is limited. Objectives: The aim of this study was to identify the risk factors for early and late recurrent ischemic stroke.

<b><i>Background:</i></b> The burden of stroke weighs heavily in developing countries where recurrence rates clearly exceed that of developed countries. The impact of nonadherence to antithrombotic treatment within this context has been poorly investigated. <b><i>Objective:</i></b> The objective of this study was to evaluate patients with recurrent ischemic stroke in Egypt and Germany with focus on stroke subtype distribution and adherence to antithrombotic therapy. <b><i>Methods:</i></b> We conducted a comparative cross-sectional retrospective cohort study enrolling consecutive patients hospitalized for recurrent ischemic stroke in 2017 in 2 academic centers. Data were collected on demographics, risk factors, stroke subtypes, and medication adherence. Nonadherence to antithrombotic agents was analyzed at the time point of index stroke (recurrent stroke). Predictors of nonadherence were analyzed using logistic regression. <b><i>Results:</i></b> A total of 373 Egyptian and 468 German patients with ischemic stroke were included. The proportion of recurrent ischemic stroke among all patients was higher in the Egyptian cohort compared to the German cohort (33 vs. 10%, <i>p</i> &#x3c; 0.05). Small-vessel occlusion stroke was the most frequent subtype in Egyptians, with a significantly greater proportion than in Germans (45 vs. 26%, <i>p</i> &#x3c; 0.05). Nonadherence to antiplatelets at the time point of the recurrent stroke was higher in Egyptians than in Germans (82 vs. 19%, <i>p</i> &#x3c; 0.001). Low educational attainment among Egyptians (OR 0.14, 95% CI [0.00–0.19], <i>p</i> &#x3c; 0.01) and high comorbidity scores among Germans (OR 2.45, 95% CI [1.06–5.66], <i>p</i> &#x3c; 0.05) were found to be predictors of nonadherence to antithrombotic treatment. <b><i>Conclusions:</i></b> The large stroke recurrence burden in Egypt may be partly explained by differing adherence to secondary preventative antithrombotic pharmacotherapy. Predictors of medication nonadherence have to be addressed to reduce stroke recurrence disparities.

Background and purpose About 10-15%of all ischemic strokes occur in young adults ,limited researches have specifically addressed stroke in the young, also, the etiology of ischemic stroke in the young are heterogeneous and can be relatively uncommon the purpose is to identify different risk factors of stroke in young and elderly and predictors of in hospital mortality patient and method: consecutive 197 patient with acute ischemic stroke admitted to neurology department, Sohag university hospital subdivided into two groups according to the age and the cut of point between young and elderly is 50-year, clinical characteristics, risk factors and hospital mortality was compared in both groups Results: The prevalence of Rheumatic heart disease is common in ischemic stroke in young adult than elderly while hypertension is the most prevalence vascular risk factor, Charlson comorbidity index is independent predictor of hospital mortality of ischemic stroke in elderly Conclusion: Rheumatic heart disease still prevalent in young adult in a sample of Egyptian population, hypertension is the most important modifiable risk factor Charlson comorbidity index and Scandinavian stroke scale on admission are predictors of hospital mortality in elderly and young adult respectively

Background: thrombolysis is the only approved pharmacological treatment for acute stroke. It acts as a mediator of recanalization and sometimes causes secondary hemorrhage depending on the size of the ischemic lesion, little is known about the efficacy and hemorrhagic complication of thrombolytic therapy, we aim to identify clinical predictors of hemorrhagic transformation. Methods: a cross-sectional comparative study in Sohag University Hospital for 1226 acute ischemic stroke patient admitted to our department from 1 st April 2019 till 31 st March 2020, of the 21 patients treated with thrombolytic therapy further subdivided into two groups; (Group A): patients who didn't complicate with hemorrhagic transformation and (group B) patients who developed hemorrhagic transformation after receiving intravenous thrombolysis, the correlation between hemorrhagic transformation and clinical characteristic, vascular risk factors, and demographic data is done. Results: We found a small percentage (1.7%) of acute ischemic stroke patients receiving thrombolytic therapy. Old age, ischemic heart disease, high admission NIHSS on admission, and NIHSS 24h after admission are associated with hemorrhagic transformation with p-value (0.024), (0.048), (0.085), and (0.001) respectively. Patients treated with thrombolytic therapy have statistically significant improvement in NIHSS 24h after admission in comparison to the admission NIHSS with a p-value (< 0.001). Conclusion: Elderly, high NIHSS on admission, and tachycardia are associated with hemorrhagic transformation following treatment with IV thrombolytic therapy, Despite the updated management of acute ischemic stroke only a small percentage (1.7%) of acute ischemic stroke patients receiving thrombolytic therapy, this in need of further investigations.