Hypertensive retinopathy and the risk of hemorrhagic stroke

Background Hemorrhagic stroke and hypertensive retinopathy are known end organ damage, with hemorrhagic stroke having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and hemorrhagic stroke. Methods All patients with with hypertension with and...

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Main Author:	A/L Thiagarajah, Ramani
Format:	Thesis
Language:	English
Published:	2018
Subjects:	RC31-1245 Internal medicine
Online Access:	http://eprints.usm.my/47847/1/Dr.%20Ramani-24%20pages.pdf
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spelling	my-usm-ep.478472020-11-03T08:44:41Z Hypertensive retinopathy and the risk of hemorrhagic stroke 2018-05 A/L Thiagarajah, Ramani RC31-1245 Internal medicine Background Hemorrhagic stroke and hypertensive retinopathy are known end organ damage, with hemorrhagic stroke having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and hemorrhagic stroke. Methods All patients with with hypertension with and without hemorrhagic stroke were recruited. Funduscopic examination was performed and then graded based on Wong and Mitchell hypertensive retinopathy classification. Clinical and radiological parameter included are demography, vital signs, Glasgow Coma Scale(GCS) on admission, clot volume, site of clot, Intra-Cerebral Hemorrhage (ICH) score and Glasgow Outcome Scale (GOS) score. Data were collected and correlated with the severity of hypertensive retinopathy. Results Fifty hypertensive patient without hemorrhagic stroke and fifty one patients with hemorrhagic stroke were recruited. In the hemorrhagic stroke group, 21 had low severity (normal/mild retinopathy changes) accounting for 41.2% and 30 patients had high severity (moderate and severe retinopathy). In the non hemorrhagic stroke patients 49 had low severity and 1 had high severity (p value 0.001). Low severity showed better GCS score on admission as compared to high severity, (p value of 0.003). Low severity also showed a clot volume less than 30ml, (p value 0.001) and also statistically significant with an ICH score of between 0-2 in most of the patients, (p value 0.006). Lastly, we compared the GOS score of patients and found a favourable outcome of GOS score 4-5 in low severity retinopathy for 17 patients with only 4 having unfavourable outcome (GOS score 1-3). As for high severity, 23 patients hadunfavourable outcome with 7 having favourable outcome, this was statistically significant, (p value of 0.001). Conclusion Low severity retinopathy were found to have small clot volume and most likely treated by medical management and better outcome. With high severity retinopathy had larger clot volume and requiring surgical intervention and poorer outcome. 2018-05 Thesis http://eprints.usm.my/47847/ http://eprints.usm.my/47847/1/Dr.%20Ramani-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RC31-1245 Internal medicine
spellingShingle	RC31-1245 Internal medicine A/L Thiagarajah, Ramani Hypertensive retinopathy and the risk of hemorrhagic stroke
description	Background Hemorrhagic stroke and hypertensive retinopathy are known end organ damage, with hemorrhagic stroke having deleterious consequence to the patients. This study is to correlate between hypertensive retinopathy and hemorrhagic stroke. Methods All patients with with hypertension with and without hemorrhagic stroke were recruited. Funduscopic examination was performed and then graded based on Wong and Mitchell hypertensive retinopathy classification. Clinical and radiological parameter included are demography, vital signs, Glasgow Coma Scale(GCS) on admission, clot volume, site of clot, Intra-Cerebral Hemorrhage (ICH) score and Glasgow Outcome Scale (GOS) score. Data were collected and correlated with the severity of hypertensive retinopathy. Results Fifty hypertensive patient without hemorrhagic stroke and fifty one patients with hemorrhagic stroke were recruited. In the hemorrhagic stroke group, 21 had low severity (normal/mild retinopathy changes) accounting for 41.2% and 30 patients had high severity (moderate and severe retinopathy). In the non hemorrhagic stroke patients 49 had low severity and 1 had high severity (p value 0.001). Low severity showed better GCS score on admission as compared to high severity, (p value of 0.003). Low severity also showed a clot volume less than 30ml, (p value 0.001) and also statistically significant with an ICH score of between 0-2 in most of the patients, (p value 0.006). Lastly, we compared the GOS score of patients and found a favourable outcome of GOS score 4-5 in low severity retinopathy for 17 patients with only 4 having unfavourable outcome (GOS score 1-3). As for high severity, 23 patients hadunfavourable outcome with 7 having favourable outcome, this was statistically significant, (p value of 0.001). Conclusion Low severity retinopathy were found to have small clot volume and most likely treated by medical management and better outcome. With high severity retinopathy had larger clot volume and requiring surgical intervention and poorer outcome.
format	Thesis
qualification_level	Master's degree
author	A/L Thiagarajah, Ramani
author_facet	A/L Thiagarajah, Ramani
author_sort	A/L Thiagarajah, Ramani
title	Hypertensive retinopathy and the risk of hemorrhagic stroke
title_short	Hypertensive retinopathy and the risk of hemorrhagic stroke
title_full	Hypertensive retinopathy and the risk of hemorrhagic stroke
title_fullStr	Hypertensive retinopathy and the risk of hemorrhagic stroke
title_full_unstemmed	Hypertensive retinopathy and the risk of hemorrhagic stroke
title_sort	hypertensive retinopathy and the risk of hemorrhagic stroke
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2018
url	http://eprints.usm.my/47847/1/Dr.%20Ramani-24%20pages.pdf
_version_	1747821839983312896

Hypertensive retinopathy and the risk of hemorrhagic stroke

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