神経学的障害

Stroke of Diabetic Subject: Experience of The Neurology Service of Cocody Teaching Hospital at Abidjan (Ivory Coast)

Abstract

Zakaria Mamadou, Ange-Eric Assouan Kouamé, Christian Tanoh, Soumaila Boubacar, Eric Bila Lamou Gueumekane, Fataoulaye Soumana, Ibrahim Nargoungou, Youssoufa Maiga and Aka-Anghui Evelyne Diarra

Introduction: Diabetes influences the clinical and evaluative profile of stroke. Age of up come type, the severances are as well the parameters which intervenes in the evolution.

Objectives: It describes the epidemiologic profile, clinical scannographic and evaluative of hospitalized patients for cerebro-vascular accident associated to diabetes.

Methodology: It was about a retrospective and descriptive study on 2 years, realized in the general service of Neurology and at Neurovascular unit of Cocody Teaching Hospital. All patients hospitalized for stroke, diabetes know or discovered during hospitalization was included. We have studied the epidemiologic data, clinic, scannographic and the evolution in the process of hospitalization. The TOAST classification was used for the etiologic classification of ischemic stroke.

Results: 79 cases of stroke associated to diabetes were diagnose on 596 patients hospitalized for stroke, the hospitalized prevalence is 13.25%. The sex ratio was from 0.79 with an average age of 64.6 years. The diabetes type II predominated with 97.5% of cases. 79.2% of patients know they were diabetic but these ones, 61.9% were unobservant to their anti-diabetic treatment. High blood pressure was associated to diabetes in 87.3% of cases. The percentage of recidivist stroke was from 27.8%. The clinical examination found a hemi corporal motor deficit in 91.6% of cases, a vigilance disorder found in 31.6% of cases and a motor aphasia in 26% of cases. Ischemic vascular cerebral accidents were predominating in 85% in cases against 21.5% of hemorrhagic stroke cases. The arteriolosclerosis was retained as etiologic of ischemic stroke in 56.5% of patients and High blood pressure in 100% of cases of Hemorrhagic stroke. We note a significant statistically correlation between the increase of HbA1C rate and the intra-hospital mortality.

Conclusion: Stroke from diabetic is frequent, severe and highly dominated by lacunar infarcts in our context.