Evaluation of serum oxidant/antioxidant balance in patients with acute stroke

OBJECTIVES

To investigate the alterations in the oxidant-antioxidant balance in patients with acute ischaemic stroke, and to locate any correlation between oxidant/antioxidant parameters and the National Institute of Health Stroke Scale.

METHODS

The case-control study was conducted at the Neurology Department of Dicle University Medical Faculty, Diyarbakir, Turkey, from June 2010 to June 2011. Blood samples were obtained from 53 patients with ischaemic stroke and 40 healthy controls without any history of ischaemic stroke or systemic disease. Venous blood was obtained within 24 hour after stroke onset. Serum malondialdehyde, total anti-oxidant capacity, paraoxanase and superoxide dismutase were measured. SPSS 11.5 used for statistical analysis.

RESULTS

There was no difference between the cases and the controls regarding age [64.5 +/- 15.8 and 66.3 +/- 13.9 respectively], gender [27 (51%) / 26 (49%), and 19 (48%) / 21 (52%) respectively], obesity [15(28.3%) and 13(37.5%), respectively], and hypertension [30 (56.6%) and 23 (57.5%), respectively]. The cases had higher concentrations of malondialdehyde (147.3 +/- 59.3 vs. 112.4 +/- 28.5 nmol/gr protein, p < 0.001), and superoxide dismutase (4.40 +/- 0.79 vs. 3.35 +/- 0.51, p < 0.001) compared to the controls. However, the cases had lower concentrations of paraoxanase (23.2 +/- 23.7 vs 64.7 +/- 52.6, p < 0.001), total anti-oxidant capacity (0.77 +/- 0.38 vs. 0.95 +/- 0.30, p < 0.015), and nitric oxide (10.8 +/- 7.1 vs. 17.5 +/- 2.4 micromol/gr protein, p < 0.001), compared to the controls. In the stroke group, a significant negative correlation was found between the National Institute of Health Stroke Scale and total anti-oxidant capacity activity (p < 0.021, r = -0.32).

CONCLUSION

The results support the hypothesis that sufficient anti-oxidant capacity has a beneficial effect on the clinical severity of acute ischaemic stroke.

Pregnancy-related strokes in southeast Turkey

OBJECTIVE

To evaluate the presentation, timing, etiology, risk factors, mortality, and outcome of ischemic stroke (IS), intracerebral hemorrhagic stroke (ICH/HS), and cerebral venous thrombosis (CVT) occurring during pregnancy and the postpartum period in southeast Turkey.

METHODS

The study was carried out from September 2003 to September 2005 at the emergency department of Dicle University Hospital in the southeast part of Turkey. Thirty-eight stroke patients, 18-42 years of age with a diagnosis of stroke during pregnancy or within 6 weeks of delivery were included. The records were retrospectively reviewed for presentation, gestational ages, strokes subtypes and time, stroke sort, stroke place, etiology, risk factors, hospital stay, mortality, and outcome.

RESULTS

Thirty-eight patients were identified, including 18 with IS, 15 with ICH, and 5 patients with CVT. Most events (89.5%) occurred in the third trimester and the postpartum period. A definable cause was identified in 61.1% of IS and 60% of CHS. Causes of IS include pre-eclampsia or eclampsia (22.2%), hypercoagulable states (16.7%), and a diverse array of other causes, including cardio embolism (5.5%) and hypotension (16.7%). Pre-eclampsia/eclampsia (46.7%) and ruptured atriovenous malformation (6.7%) were the primary causes of ICH. The mortality rate for all patients was 34.2%.

CONCLUSION

The etiology of stroke in pregnancy and the postpartum period is diverse. Strokes are most likely to occur in the third trimester and postpartum period and cluster in the first postpartum week. Mortality is high in patients with ICH. Pre-eclampsia and eclampsia are common causes of strokes.