Clinical Profile and Risk Factors of Massive Middle Cerebral Artery Infarction in a Tertiary Care Centre in Central Tamilnadu

Abstract

Introduction: Large territory middle cerebral artery strokes are devastating events that result in high rates of disability and death. Nearly half of all stroke survivors never regain functional independence. Current research aimed to study the clinical profile and risk factors of massive middle cerebral artery (MCA) infarction and to study the relation of alcoholism and its pattern to massive MCA stroke. Material and methods: Patients admitted with massive MCA infarct with an early ischemic change on CT affecting at least >50% of the MCA territory within 48 hours of symptom onset were included in the study. Stroke mimics and those with history of previous stroke were excluded. Study design was a cross sectional, observational study. Results: A total of 60 cases were analyzed. Mean age was 55.4. 35% subjects had NIHSS >20.Diabetes was present in 18. Total of 60% were alcoholics, and 83% of males were alcoholics.31 subjects were heavy drinkers. Binge drinking was present in 30%.Mean duration of alcohol was 9.5 years. Average intake per day was 120 ml. Mean ASPECT score in the subjects was 3. 25 patients had a MRS 4 at discharge. Craniotomy done in 6 cases. Total death were 17(29%). Aspiration pneumonia was the common cause of death (5). Conclusion: NIHSS 20 or more was associated with adverse outcome (P value <0.05).60% were alcoholics. Binge intake in 30%(associated with adverse outcome P value <0.05). Mean Aspect score was 3 (3 or less associated with adverse outcome P value <0.05).