Clinical, Radiological, and Risk Factor Profile of Large Artery Ischemic Stroke in a Tertiary Care Hospital
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Abstract
Background: Acute stroke is a leading cause of mortality and long-term disability worldwide. Large-artery atherosclerosis constitutes an important subtype of ischemic stroke and is associated with larger infarct volumes and poorer clinical outcomes. The present study aimed to characterize the clinical features, radiological findings, and risk-factor profile of patients with large-artery ischemic stroke.
Methods: This retrospective cross-sectional study was conducted in the Department of Neurology, SRMS IMS, over a two-year period (August 2022–January 2024). Consecutive patients aged ≥18 years who presented within 48 hours of symptom onset and had imaging-confirmed large-artery ischemic stroke (infarct diameter ≥1.5 cm on CT or MRI) according to TOAST criteria were included. Demographic, clinical, laboratory, and neuroimaging data were recorded. Statistical analysis was performed using SPSS version 27.0.
Results: A total of 315 patients were enrolled (mean age 65 years; 53.9% male). Eighty-one percent of patients were older than 45 years, and 65.4% belonged to lower socioeconomic strata. Hypertension (64.1%) was the most prevalent risk factor, followed by diabetes mellitus (40.6%), smoking (30.5%), and alcohol consumption (28.9%). The most frequent clinical features were motor weakness (hemiparesis/hemiplegia) in 92.7%, altered sensorium in 82.5%, and speech impairment in 72.4%. Middle cerebral artery (MCA) territory infarcts accounted for 83.5% of cases. A statistically significant association was observed between infarct size and stroke severity assessed by NIHSS (p = 0.003).
Conclusion: Large-artery ischemic stroke predominantly affected older adults and males from lower socioeconomic backgrounds. Hypertension, diabetes, and smoking were the leading modifiable risk factors. MCA territory involvement and motor weakness were the dominant clinical–radiological features. Infarct size on neuroimaging showed a strong linear relationship with clinical severity and may serve as a useful predictor of stroke severity.