Association between Admission Hyperglycemia and Outcome in Acute Ischemic Stroke Cases: an Observational Study

Stroke is one of the leading causes of death and disability worldwide and more so in underdeveloped countries like Bangladesh where health support system including rehabilitation is not expectedly available.At least 50% of the neurological disorder in a general hospital is of stroke.World Health Organizasion (WHO) defined Stroke as rapidly developiong clinical signs of focal or global disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death, with no apparent cause other than vascular origin 1 .Most of the stroke is due to cerebral infarction (80%) the rest is due to haemorrhage.Modifiable risk factors for stroke include hypertension, diabetes, a trial fibrillation, dislipidemia, smoking and alcohol abuse.About one third of patients with acute stroke and no prior diagnosis of diabetes have hyperglycemia during acute phase of stroke 2,9,10 and is associated with worse neurological outcome and increased stroke mortality 11,12,13 .Weather this is an acute stress response or a reflexion of underlying diabeties is controversial 2,14,15,16 .Hyperglycemia has been reported to worsen the tolerance of the brain to is chemia (3,4) .Both acute and chronic hyperglycaemia are associated with increased oedema and infarct size 5,7,8,17 and with reduced cerebral blood flow and cerebrovascular reserve 6,18 .The early recognition of disorder of glucose metabolism in stroke patients is important because hyperglycemia during the acute phase worsens the outcome probably by reducing the salvage of penumbral tissue medicated by high lactate level of brain tissue 5,19,20,21 .