Browsing by Author "Kate, M"

Now showing 1 - 3 of 3
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    Early risk and predictors of cerebrovascular and cardiovascular events in transient ischemic attack and minor ischemic stroke
    (NEUROLOGY INDIA, 2012) Kate, M; Sylaja, PN; Chandrasekharan, K; Balakrishnan, R; Sarma, S; Pandian, JD
    Background: Transient ischemic attack (TIA) and minor ischemic stroke (MIS) are associated with early recurrence and deterioration respectively. The aim of the present study was to assess the risk of new cerebrovascular and cardiovascular events in a prospective, emergently enrolled patient cohort with TIA and MIS and the predictors of risk. Materials and Methods: Patients with TIA and MIS (NIH Stroke Scale [NIHSS] <= 5) presenting within the first 48 h between July 2008-June 2009 were prospectively enrolled. The primary outcome was new-onset stroke, TIA, cardiovascular events and vascular death at 90 days and early deterioration in patients with minor stroke. The 90-day outcome was also assessed (excellent outcome; modified Rankin scale [mRS] <= 2). Results: Eighteen (15.3%) of the 118 patients enrolled developed new cerebrovascular or cardiovascular events during the 90 days of follow-up, nine (50%) of which occurred within seven days. Of the all new events 5.9% (7/118) had new stroke, 4.2% (5/118) patients developed early deterioration, 2.5% (3/118) patients had recurrent TIA and 2.5% (3/118) had cardiovascular events at 90 days. Eight (6.7%) patients had poor outcome at 90 days (mRS>2). The factors predicting new vascular events were presence of coronary artery disease (CAD), and stroke etiology being large artery atherosclerosis (LAA). Conclusion: In patients with TIA and MIS, despite urgent evaluation and aggressive management, the short-term risk of stroke and other vascular events is high. Those with CAD and LAA should be monitored closely for early deterioration.
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    Imaging and Clinical Predictors of Unfavorable Outcome in Medically Treated Symptomatic Intracranial Atherosclerotic Disease
    (JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, 2014) Kate, M; Sylaja, PN; Kesavadas, C; Thomas, B
    Background: Patients with symptomatic intracranial atherosclerotic disease (sICAD) have an increased risk of stroke and vascular death. The aim of the study was to evaluate the natural history and outcome of patients with sICAD treated medically. Methods: The study population was first-ever transient ischemic attack (TIA) or stroke patients presenting to our institute who on vascular imaging had isolated intracranial atherosclerosis as cause of their symptoms and have a follow-up of 90 days. Unfavorable outcome was defined as occurrence of TIA, stroke, acute coronary event, and/or vascular death. Results: Fifty-three (11.8%) of the 449 ischemic stroke patients had sICAD. The risk of stroke in sICAD was 8.9%, 11.1%, 13.3%, and 15.6% in first 7 days, 30 days, 90 days, and 1 year, respectively. Five (11.1%) had cardiovascular events and accounted for 50% of mortality. The predictors of unfavorable outcome were presented as limb weakness (85.7% versus 58.8%, hazard ratio 1.5; 95% confidence interval [CI], .05-.9; P = .04), National Institutes of Health Stroke Scale (NIHSS) score 8 at admission (50% versus 5.9%, hazard ratio 8.5; 95% CI, .007-.5; P = .02), magnetic resonance imaging (MRI) with multiple diffusion-weighted imaging (DWI) lesions (65.4% versus 26.7%; 95% CI,.04-. 7; P = .01), and angiography suggestive of diffuse atherosclerosis (50% versus 11.8%; 95% CI, odds ratio .02-. 7; P = .009). On stepwise multiple regression, variables for unfavorable outcome were NIHSS score of 8 or more at admission (P = .001), multiple DWI lesion on MRI (P 5.04), and diffuse atherosclerosis on angiography (P = .006). Conclusion: The patients with sICAD have a high risk of stroke and cardiac events even on aggressive medical treatment. Clinical and imaging features can identify this high-risk group.
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    Intracerebral hemorrhages in Vogt-Koyanagi-Harada disease
    (NEUROLOGY INDIA, 2009) Baheti, NN; Cherian, A; Kate, M; Krishnan, S; Thomas, B