Ischemic stroke in the intensive care unit: About 75 cases

Abstract

Stroke is characterized by the sudden onset of a focal neurological deficit and is a frequent and potentially serious pathology that constitutes a medical and, sometimes, surgical emergency. The objective of this work is to elucidate the epidemiological, clinical, paraclinical, therapeutic and evolutionary aspects of the cerebral vascular accident in the environment of intensive care unit in order to define the factors of bad prognosis: This is a retrospective study including all patients hospitalized in A1 intensive care unit of HASSAN II University Hospital of Fes for acute ischemic stroke(AIS) over a period of 7 years since 2014 until 2020. We collected 75 patients over a period of 7 years (2014-2020), 55% of our patients are male, the average age is 65.52 years. Arterial hypertension, heart disease and diabetes are the main risk factors, and hemiplegia is the main focal neurological sign encountered. Sylvian cerebral infarcts (territory of the middle cerebral artery) predominate (64%), followed by the territory of the posterior cerebral artery (9.3%) and the basilar trunk (4.3%). The main prognostic factors related to mortality were: initial GCS, presence of vital distress, mechanical ventilation, inhalation, infection and cerebral involvement. A hemicraniectomy was performed in 16% of our patients with an estimated mortality of 57%. Stroke represents: The first cause of acquired motor disability in adults; The second cause of major cognitive impairment after Alzheimer's disease. The improvement of the prognosis depends on the quality of primary and secondary prevention and on the rapidity of diagnostic and therapeutic management in the acute phase.