Clinical Neurology and Neuroscience

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Mortality and Morbities of Severe Stroke in Limited Ressources Neurological Service

Received: 22 February 2019    Accepted: 09 April 2019    Published: 29 June 2019
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Abstract

Introduction: Severe strokes have poor prognosis by their heavy motor and cognitive consequences. Objective: To describe the epidemiological, clinical and therapeutic aspects of these strokes. Material and Method: A retrospective and analytical study was conducted from January 2015 to December 2016 in the neurology department of our University Hospital. The diagnosis of severe stroke was based on clinical criteria (NIHSS score greater than 17, Glasgow score less than 9, and a WFNS stage greater than or equal to IV); and CT scan criteria (stroke location in the posterior fossa, carotid and Sylvian malignant infarction, cerebral hemorrhage with ventricular flood and mass effect). Results: We recorded 1964 strokes and 163 patients had severe stroke with a frequency of 8.3%. Of the 163 severe strokes, ischemic were observed in 38.7% and hemorrhagic for 61.3%. The average age was 55.8 ± 12.8. The motor deficit (76.1%) and disturbances of consciousness (62.6%) were the most admission signs. High blood pressure was the main risk factor (64.8%) and the etiology of hemorrhage in 83.5%. Atherosclerosis was the main etiology (86.4%) of ischemia. The hemorrhagic lesions location was diencephalic (67.7%) and brainstem (21.7%). Overall mortality was 44.8%, including 72.6% of early mortality due to haemorrhage. Predictive factors of mortality were the high NIHSS score, low Glasgow score, presence of ventricular flood, and high volume of hematoma. Conclusion: The high incidence of severe stroke and its early mortality rate demonstrate that many challenges remain to be done to improve the management of patients and avoid disabling sequelae.

DOI 10.11648/j.cnn.20190302.15
Published in Clinical Neurology and Neuroscience (Volume 3, Issue 2, June 2019)
Page(s) 50-57
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Epidemiology, Clinical, Severe Stroke, Treatment

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Author Information
  • Neurology Department, Campus University Teaching Hospital, University of Lomé, Lomé, Togo

  • Neurology Department, Campus University Teaching Hospital, University of Lomé, Lomé, Togo

  • Neurology Department, Campus University Teaching Hospital, University of Lomé, Lomé, Togo

  • Neurology Department, Campus University Teaching Hospital, University of Lomé, Lomé, Togo

  • Radiology and Medical Imagery Services, Campus University Teaching Hospital, University of Lomé, Lomé, Togo

  • Neurology Department, Campus University Teaching Hospital, University of Lomé, Lomé, Togo

  • Neurology Department, Campus University Teaching Hospital, University of Lomé, Lomé, Togo

  • Radiology and Medical Imagery Services, Campus University Teaching Hospital, University of Lomé, Lomé, Togo

  • Neurology Department, Campus University Teaching Hospital, University of Lomé, Lomé, Togo

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  • APA Style

    Komi Assogba, Kossivi Apetse, Watouo Marlène Djobosse, Lantam Sonhaye, Nynèvi Anayo, et al. (2019). Mortality and Morbities of Severe Stroke in Limited Ressources Neurological Service. Clinical Neurology and Neuroscience, 3(2), 50-57. https://doi.org/10.11648/j.cnn.20190302.15

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    ACS Style

    Komi Assogba; Kossivi Apetse; Watouo Marlène Djobosse; Lantam Sonhaye; Nynèvi Anayo, et al. Mortality and Morbities of Severe Stroke in Limited Ressources Neurological Service. Clin. Neurol. Neurosci. 2019, 3(2), 50-57. doi: 10.11648/j.cnn.20190302.15

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    AMA Style

    Komi Assogba, Kossivi Apetse, Watouo Marlène Djobosse, Lantam Sonhaye, Nynèvi Anayo, et al. Mortality and Morbities of Severe Stroke in Limited Ressources Neurological Service. Clin Neurol Neurosci. 2019;3(2):50-57. doi: 10.11648/j.cnn.20190302.15

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  • @article{10.11648/j.cnn.20190302.15,
      author = {Komi Assogba and Kossivi Apetse and Watouo Marlène Djobosse and Lantam Sonhaye and Nynèvi Anayo and Panabalo Waklatsi and Abdoulah Blakime and Victor Kokou Adjenou and Koffi Agnon Ayélola Balogou},
      title = {Mortality and Morbities of Severe Stroke in Limited Ressources Neurological Service},
      journal = {Clinical Neurology and Neuroscience},
      volume = {3},
      number = {2},
      pages = {50-57},
      doi = {10.11648/j.cnn.20190302.15},
      url = {https://doi.org/10.11648/j.cnn.20190302.15},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.cnn.20190302.15},
      abstract = {Introduction: Severe strokes have poor prognosis by their heavy motor and cognitive consequences. Objective: To describe the epidemiological, clinical and therapeutic aspects of these strokes. Material and Method: A retrospective and analytical study was conducted from January 2015 to December 2016 in the neurology department of our University Hospital. The diagnosis of severe stroke was based on clinical criteria (NIHSS score greater than 17, Glasgow score less than 9, and a WFNS stage greater than or equal to IV); and CT scan criteria (stroke location in the posterior fossa, carotid and Sylvian malignant infarction, cerebral hemorrhage with ventricular flood and mass effect). Results: We recorded 1964 strokes and 163 patients had severe stroke with a frequency of 8.3%. Of the 163 severe strokes, ischemic were observed in 38.7% and hemorrhagic for 61.3%. The average age was 55.8 ± 12.8. The motor deficit (76.1%) and disturbances of consciousness (62.6%) were the most admission signs. High blood pressure was the main risk factor (64.8%) and the etiology of hemorrhage in 83.5%. Atherosclerosis was the main etiology (86.4%) of ischemia. The hemorrhagic lesions location was diencephalic (67.7%) and brainstem (21.7%). Overall mortality was 44.8%, including 72.6% of early mortality due to haemorrhage. Predictive factors of mortality were the high NIHSS score, low Glasgow score, presence of ventricular flood, and high volume of hematoma. Conclusion: The high incidence of severe stroke and its early mortality rate demonstrate that many challenges remain to be done to improve the management of patients and avoid disabling sequelae.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Mortality and Morbities of Severe Stroke in Limited Ressources Neurological Service
    AU  - Komi Assogba
    AU  - Kossivi Apetse
    AU  - Watouo Marlène Djobosse
    AU  - Lantam Sonhaye
    AU  - Nynèvi Anayo
    AU  - Panabalo Waklatsi
    AU  - Abdoulah Blakime
    AU  - Victor Kokou Adjenou
    AU  - Koffi Agnon Ayélola Balogou
    Y1  - 2019/06/29
    PY  - 2019
    N1  - https://doi.org/10.11648/j.cnn.20190302.15
    DO  - 10.11648/j.cnn.20190302.15
    T2  - Clinical Neurology and Neuroscience
    JF  - Clinical Neurology and Neuroscience
    JO  - Clinical Neurology and Neuroscience
    SP  - 50
    EP  - 57
    PB  - Science Publishing Group
    SN  - 2578-8930
    UR  - https://doi.org/10.11648/j.cnn.20190302.15
    AB  - Introduction: Severe strokes have poor prognosis by their heavy motor and cognitive consequences. Objective: To describe the epidemiological, clinical and therapeutic aspects of these strokes. Material and Method: A retrospective and analytical study was conducted from January 2015 to December 2016 in the neurology department of our University Hospital. The diagnosis of severe stroke was based on clinical criteria (NIHSS score greater than 17, Glasgow score less than 9, and a WFNS stage greater than or equal to IV); and CT scan criteria (stroke location in the posterior fossa, carotid and Sylvian malignant infarction, cerebral hemorrhage with ventricular flood and mass effect). Results: We recorded 1964 strokes and 163 patients had severe stroke with a frequency of 8.3%. Of the 163 severe strokes, ischemic were observed in 38.7% and hemorrhagic for 61.3%. The average age was 55.8 ± 12.8. The motor deficit (76.1%) and disturbances of consciousness (62.6%) were the most admission signs. High blood pressure was the main risk factor (64.8%) and the etiology of hemorrhage in 83.5%. Atherosclerosis was the main etiology (86.4%) of ischemia. The hemorrhagic lesions location was diencephalic (67.7%) and brainstem (21.7%). Overall mortality was 44.8%, including 72.6% of early mortality due to haemorrhage. Predictive factors of mortality were the high NIHSS score, low Glasgow score, presence of ventricular flood, and high volume of hematoma. Conclusion: The high incidence of severe stroke and its early mortality rate demonstrate that many challenges remain to be done to improve the management of patients and avoid disabling sequelae.
    VL  - 3
    IS  - 2
    ER  - 

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