الفهرس 
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Abstract
SUMMARY
SUMMARY
Stroke is the most common -life threatening neurological disease
and it is the third most common cause of death after coronary heart
disease and cancer,
Uptill now, there is no rules formulated to allow the physician to
predict the course of the focal ischemic cerebral lesions.
The aim of t”is study, is to answer in a more or less definite
scientific and if possible, measurable ways the questions raised by the
patient and family about prognosis and prognostic factors of ischemic
stroke.
In our study we included prospectively 100patients, with 1st, single
stroke 59 of them were males and 41 were females. Within the 1st 30
hours from the onset. Their ages varied from 42 years to 86 years old.
55% of palients live in Urban areas and 45% in Rural areas.
All patients subjected to full general physical examination, full
neurological examination, neurological assessment on arrival using the
following scales Glasgow coma scale, Mini- mental state, Canadian
neurological scale and National institute of Heath (N.J. H) scale.
All patients were tested for the following: blood glucose level,
platelet count, white blood corpuscles, hematocrit, sodium, Potassium,
cholesterol, triglycerides, blood urea and serum creatinine.
,it
SUMMARY
I. All patients subjected to CAT scan and the site, size midline shift
were determined.
Follow up assessment Were attempted on all living patients at out
patient clinic in Benha University Hospital or at patients home twelve
months after the· onset. Functional out come after I year assessed by the
following scales. Motoricity index, Functional ambulation categories,
Barthel ADL scale, 4 point scale.
Our results showed that 42% of our patients have good prognosis,
35% have moderate p~ogoosisand 23% have worse prognosis.
Regarding the age; Our results showed that patient with a mean
age 60.6 ± 5.01 (S.D). have good prognosis, patient with a mean age
64.1± 5.6 (S.D) have moderate prognosis and patients with a mean
68.7±6.2 .(S.D) have worse prognosis so, the results concluded that the
older the patient including in this study the worse Wasthe prognosis and
we consider age one of the prognostic factor in ischemic stroke.
Regarding the level of consciousness, our results showed that
68.8% of fully conscious patients and good prognosis, 26.9% of drowsy
patients had good prognosis and lOO% of patients with deep coma had
Worseprognosis.
So, the result concluded that the prognosis Was related to
deteriorating level of consciousness and the level of consciousness
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CONCLUSION
represent the most important predictor of out come (short term out come
and long term out come).
Regarding cognitive dysfunction, our results showed that 27.2%
of patients with higher cerebral dysfunction had good prognosis, 54.5%
of them had moderate prognosis and 18.3% had worse prognosis.
So, the result concluded that cognitive dysfunction represent one of
the predictor of long term outcome.
Regarding the muscle paralysis, our results showed that patients
with mild paralysis 95.2% of them had good prognosis, 4.8% had
moderate prognosis, and 0% had worse prognosis.
Patients with severe paralysis, 13.6%had good prognosis, 47.4%
had moderate prognosis and 39% had worse prognosis, and we concluded
that there is a linear correlation between the degree of paralysis and
prognosis in a sense that increase the degree of paralysis is usually faced
by bad prognosis, so, w.e consider muscle paralysis is one of the ;. ~
prognostic factors in isc”emic stroke. ’
Regarding the degree of muscle flaccidity, our results showed
that 90.3% of patients with mild degree of flaccidity had good prognosis,
9.7% had moderate prognosis and 0% had worse prognosis.•Patients with
severe muscle flaccidity, 3.8% of them had good prognosis, 52.8% had
moderate prognosis and 43.4% had worse prognosis, so we concluded
that muscle flaccidity on paralyzed side correlate positively with the short
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SUMMARY
term outcome and long term outcome. So, we considered muscle
flaccidity as one of the Prognostic factors in ischemic stroke.
Regarding unilateral neglect, our study showed that no one
patients with good prognosis had unilateral neglect, 80% of patients with
unilateral neglect had moderate prognosis and 20% had worse prognosis,
So, we concluded that patients with unilateral neglect had poor outcome
and we considered hemineglect as one of predictors ofischemic stroke.
Regarding urinary incontinence, Our results showed that 25.4%
patients with urinary incontinence had good prognosis, 35.6% had
moderate prognosis and 39% had worse prognosis and patients without
urinary incontinence, 90.2% of them had good prognosis, 9.8% had
moderate prognosis 0% had Worse prognosis, so we concluded that with
incontinence there is more risk of worse prognosis and poor outcome and
so, we considered urinary incontinence as one of the predictors of
outcome.
Regarding body temperature, our results showed that high fever
was associated with poor outcome and patients with higher temperature
have a Worse prognosis, so, we concluded that high fever is one of the
prognostic factors of i$chemic stroke.
Regarding blood glucose level, Our results showed that patients
with a mean 162.8± 53.8 (S.D) had good prognosis, patients with a mean
259.4 ± 57.5 (S.D) had moderate prognosis and patients with a mean
269.9 ± 88.8 (S.D) ,ha.4 worse prognosis so, we showed that
hyperglycemia at the onset of admission had negative influence on
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SUMMARY
prognosis and outcome and we considered blood glucose level at
admission is one of the prognostic factors in ischemic stroke.
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Regarding blood pressure at the onset, our results showed that
systolic and diastolic blood pressure at admission had negative influence
on out come, the worse group had higher degree of hypertension with a
mean (193.5 ± 43.4 (S.D) systolic), (116.5 ± 21.9 (S.D)diastolic)in
comparison to good outcome group with a mean (163.8 ± 17.4 (S.D)
systolic) (102.4 ± 11.0 (S.D) diastolic) and moderategroup 064.5 ±15.3
(S.D) systolic) (101.7 ± 8.6 (S.D) diastolic). So, we considered blood
pressure at admission is one of prognostic factors inischemic stroke.
Regarding cardiae comorbidity, our results showed that patients
with cardiac disease like atrial fibrillation 21.4% of them had good
prognosis, 46.4% had moderate prognosis and 32.2% had Worseoutcome.
So, we considered cardiac comorbidity is one of the prognostic factors in
ischemic stroke.
Regarding the size of !nfarc:tion, our results showed thaf84.1% of
patients with small infarction had good prognosis, 15.9% of them had
moderate prognosis and 0.0% had worse prognosis. In comparison to
patients with large infarction, 0.0% had good prognosis, 12.5% had
moderate prognosis, and 87.5% had worse prognosis. So, we concluded
that the size of infarction is good predictor of prognosis mainly ill
supratentorial infarct.
Regarding the white blood cells and platelets count, our results
showed that patients with a mean W.B.cs 7826.1± 1749.1 (S.D) had