Bharatpur Hospital, Chitwan, Nepal.
He has completed his bachelor’s degree in medicine and Surgery from manipal College of Medical Sciences in the year 2007. He has been served as a Deputy Medical Superintendent and a Medical Officer in Myagdi from 2009-2012. Later he is working as MD Resident in Neurology in NAMS, Bir Hospital, Nepal from the year 2012.
Atherosclerotic changes of the carotid vessel frequently underlie carotid-related cerebrovascular ischemic events. Carotid intima-media thickness (IMT) is a validated measure of atherosclerosis burden. Increased C-IMT and atherosclerotic plaques are associated with the subsequent risk of new or recurrent stroke and myocardial infarction.
This study aims to find out the carotid IMT in ischemic stroke patient and its correlation with the severity of the stroke and various risk factors of the stroke like diabetes, hypertension, dyslipidemia, family history of ASCVD, smoking etc.
A cross sectional, hospital based study was carried out from March 2014 to February 2015 at Tertiary hospital, Kathmandu. Carotid IMT was measured by high-resolution B-mode ultrasound.
A total of 62 patients with ischemic stroke were enrolled in this study. The age distribution varied from 41 to 85 years. Mean C-IMT on Right side was 1.1468 mm (SD 0.375), whereas mean CIMT on left side was 1.137 mm (SD 0.35). Majority 85.5 % had Mean IMT > 0.8 mm. 51.6% had IMT between 1-1.5 mm. Patient with single risk-factor had CIMT of 1.0526mm (SD 0.3), with no risk factors 0.0912 (SD 0.4) and with multiple risk factors had CIMT of 1.2628 (SD 0.404), the difference was statistically significant. Change in IMT on the ipsilateral side of the stroke with the IMT of the opposite side was significant (p value <0.05). This study found the significant association of CIMT with severity of clinical presentation and presence of one or more risk factors, strong correlation was seen with hypertension, diabetes, dyslipidemia, raised total cholesterol and high LDL cholesterol.
Our study reveals the importance of carotid IMT evaluation at the patients with atherosclerotic risk factors and suggests a predictive role of increased carotid IMT for ischemic stroke with severe clinical presentation and presence of other risk factors.