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 Background & Objective: Stroke is a leading cause of death and disability worldwide. It is more common in men than in women, however more than half total stroke death occur in women. Several conditions and lifestyle factors have been well established as risk factors for stroke. The purpose of this study was to asses the magnitude of classic stroke risk factors and its pattern in women.

 Methods: A total of 62 patients with first-onset ischemic stroke were accrued from neurology unit of Alavi hospital during 2002 and compared with their age-matched controls from other units of same hospital. Information concerning potential risk factor exposure status was collected by structured questionnaire at interviews. Stroke risks were estimated by calculating the odds ratios.

 Results: Significantly increased risk of stroke was found among women with hypertension (OR=8.4 CI=3.7-1.8), current smoking (OR=4.2 CI=1.1-16), diabetes (OR=3.7 CI=1.4-9.7) and heart disease (OR=3.2 CI=1.2-8.4). Association of other factors (passive smoking, Hypercholestrolemia) with stroke was not significant.

 Conclusions: Hypertension, diabetes, current smoking and heart disease are major risk factors for stroke in women. Given that the majority of these factors are either correctable or modifiable, prevention strategies should be planned in accordance with this point in order to reduce the occurrence of stroke in women.

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  Background & Objective : Despite the ever increasing use of oral contraceptives there is uncertainty about the stroke risk associated with their use. Some cases of pulmonary Emboli and stroke have been reported among women taking these pills. The present research was conducted to investigate the relationship between taking contraceptive pills and the risk of ischemic stroke.

  Methods : In a case-control study, women with definite ischemic stroke were selected from Alavi Hospital in Ardabil who had no prior stroke. The control group was age-matched ( ± 3years) to cases and were selected from other wards of the same hospital. A questionnaire was administered to elicit information about prior exposure to various risk factors, including the oral contraceptive pill (OCP). The data were analyzed by SPSS software (Ver. 12) and statistical methods such as chi-square, multivariate regression and ANOVA. The risk factor were estimated by odds ratio.

 Results: OCP consumption was associated with an increased risk of ischemic stroke (OR=5.4 95% CI=1.1-5.3), and after adjustment for other risk factors of stroke it was OR=2.7 (95% CI=0. 95-7.2) with p=0.05.

 Conclusions: According to this study there was weak evidence for an association between ischemic stroke and OCP consumption. Extended studies are needed to clarify the relationship between risk of stroke and the present/ past use of OCP.

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  Background & Objective : The role of circulating lipids in the pathogenesis of ischemic stroke remains unclear despite 3 decades of research. Since ischemic stroke is one of the important causes of death or disability in the world. Finding its risk factors can play a crucial role in health interferences.This study was conducted to investigate the relationship between blood lipids and ischemic stroke.

  Methods : This was�a case-control study conducted in 2002. The case group were patients who were definitely diagnosed to have ischemic stroke for the first time. An equal number of control subjects (with the same age and sex) were selected from other hospital wards. These two groups were compared in terms of the blood lipids. The collected data were analyzed using SPSS software (release 12) and statistical methods such as ANOVA and multivariate regression.

  Results : In this research 132 cases were compared with equal number of control subjects. The subjects in both groups were 64.1 years old on average. The mean level of total cholesterol was significantly higher in case group (p=0.001). The mean level of Triglycerides had no significant difference in two groups.

  Conclusions: Regarding the findings of the present research, offering strategies to lower the chlestrol level through primary prevention as well as drug interferences especially in the groups with other risk factors of stroke, seems to have a significant role in the prevention of ischemic stroke.

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Background & Objectives: Cerebrovascular accidents (CVA) are among the most common neurologic problems affecting people of middle and old ages and are one of the causes of seizure in these age groups. Epileptic seizure in patients with stroke occurs in the forms of early and late seizures and could be seen as simple or generalized. The aim of  this study was to evaluate the incidence of early seizure in patients with stroke.

Methods: All 716 patients with cerebrovascular accidents admitted to Imam Khomeini Hospital during the year 2002 participated in this descriptive study. The data were collected using the patients, records. The stroke was diagnosed through clinical findings, CT Scan and MRI (if necessery).

Results: Early seizures were documented in 46 (6.4%) of 716 patients, including 16 cases (5%) with atherosclerotic thrombosis, 10 (8.4%) with embolic infarction, 10 (5%) with intra cerebral hemorrhage and 10 (16.9%) with subarachnoid hemorrhage. Twenty-four (52%) out of 46 patients had Tonic- clonic seizures, 14 (30.5%) simple partial seizures, 5 (11%) complex partial seizures and 3 (6.5%) tonic-clonic status.

Conclusion: It was found that incidence of early seizures in stroke is 6.4%and early seizures are more common in subarachnoid hemorrhage and embolic infarction than embolic and atherothrombotic infarction.

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  Background & Objectives: Cerebrovascular diseases are the most common disabiling neurologic disorders and the third cause of death in the population over 45 years of age. Most of the strokes in adults are ischemic and almost one-fifth of them are due to intra- or extracranial internal carotid artery stenosis. Ultrasonography is a noninvasive, cost-effective and safe technique for evaluation of intra or extracranial vessels that is available in two methods: TCD and carotid Duplex. The present research is an attempt to investigate the appropriatens and comprehensiveness of TCD in diagnosing symptomatic significant carotid stenosis.

  Methods : This descriptive-analytical study was conducted on fifty patients admitted to the neurology ward of Imam Hospital who underwent both carotid duplex and TCD examination. Variables of blood flow velocities, collateral flow evidences and degree of carotid stenosis were assessed with both methods. The data were analyzed by SPSS (ver.11.5) using T.test, Chi-square and Fisher test.

  Results : 34 patieuts were. Male mean age of the patients was 66.70% of the subjects were above 65 and 68% of them had a history of hypertension. No statistically significant difference was seen between systolic and diatolic blood flow velocity in internal carotid artery and pulsatile index obtnined from reported by TCD and carotid Duplex. There was no statistically significant difference between the percentage of stenosis TCD finding of the patients with carotid stenosis showed collateral flow in 78.57% of the cases.

  Conclusion: Acceptable correlation of the flow velocity parameters and the percentage of carotid stenosis between TCD and Carotid Duplex results showed that the primary performance of TCD to diagnose significant carotid stenosis (that causes hemodynamic disorder) and screen ischemic cerebrovascular accident is a reliable and effective method, but for precise determination of stenosis, plaque typing and for diagnosing stenisis below 50% the performance of carotid duplex study is also necessary and to complemantory TCD.

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  Background & Objective: Cerebrovascular disease mortality rates have declined in some countries during recent decades. Changes in mortality rates over time could be attributed to changes in disease incidence or case fatality rate. Very few studies have provided information regarding survival after stroke. We aimed to determine the case-fatality rate (28 days) among patients with first-ever stroke from a population-based study in Ardabil province, Northwest of Iran.

  Methods: This study was conducted between May 2005 and February 2006, all individuals with an acute stroke who were residents in Ardabil province and hospitalized at Alavi Hospital, were registered prospectively and assessed according to standardized diagnostic criteria. The data were analyzed through SPSS, Chi square and variance analysis.

  Results: A total of 352 patients with first-ever stroke were registered, and 346 (96%) were followed up. 288 (81.8%) ischemic stroke, 16.2% (57) ICH and 2% SAH. By 28 days, 70 patients (20.3%) had died. Hypertension, diabetes and cardiac disease history were reported in 61.6%, 16.8% and 26.1% respectively and 19.8% of patients were smokers. Mean age of survivors was different from patients who died at 28 days after index event (64.2±12.9 VS 69.1±10.9, p=0.03). The proportion surviving 28 days varied from 16.2% among patients with ischemic stroke to 43% among ICH and SAH. For ischemic stroke, Survival rates were similar for men and women, whereas men with ICH had lower survival than women.

  Conclusion: Case fatality rate after first-ever stroke is substantial. Rates of mortality differ according to patients diagnosis, age, sex, and heart disease. These data highlight the importance of long-term secondary prevention.

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Background & Objectives:�Stroke is the third most common cause of death after heart disease &cancer and the most common disabling neurological disorder. The incidence increases with age, and is somewhat higher in male than in female. The main risk factor of stroke is hypertension. In last years incidence of stroke has decreased due to improvement of hypertension treatment but due to occurrence of cerebrovascular accident with normal blood pressure, in many patients with stroke. This study aimed to evaluate the frequency of mortality and morbidity in stroke patients with hypertension & normal blood pressure.

Methods:�This descriptive retrospective study, evaluated 8121 patients with stroke who were admitted at hospital (1997-2006). The inclusion and exclusion criteria were defined. Data was gathered through check list and analyzed by SPSS soft ware 10 edition and the results were compared with each other.

Results: The total mortality and morbidity rate of stroke was 13.59% who 19.3% of patients with high mean blood pressure and 10.2% of patients with normal mean blood pressure were expired due to stroke. The mortality based on age in two groups was similar and more frequent in 65 to 74 year olds. The rate of mortality and morbidity in patients with high mean blood pressure in male and female were similar but in normal mean blood pressure cases were more frequent in male than in female. Hemorrhagic stroke was the most common type of stroke in hypertensive patients (59.55%) and in normotensive patients, ischemic stroke was more frequent (37.7%). The duration from admission to death was similar in two groups and the death was highest within 72 hrs after admission.

Conclusion:�Since mortality and morbidity according to age had no significant difference in both groups. It seems other risk factors are effective in evaluating cerebrovascular accidents (prognosis).

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  Background & objectives: Ischemic stroke remains the third leading cause of invalidism and death in industrialized countries. It is suggested that renin–angiotensin system (RAS) may contribute in stroke related pathogenic mechanisms and involve in the ischemic brain damage. This study designed to investigate the role of angiotensin II (Ang II) in conjunction with AT₁ receptors in treatment of the brain injuries following transient focal cerebral ischemia in rats.

  Methods: Forty eight male Sprague-Dawley rats were studied in four groups. Sham group, ischemic control group and two ischemic groups that received candesartan (0.1mg/kg, or 0.5mg/kg) at the beginning of reperfusion period. Transient focal cerebral ischemia was induced by 60 minutes occlusion of the middle cerebral artery, followed by 24 hours reperfusion. At the end of the reperfusion period, neurological deficit score (NDS) was performed. Total cortical and striatal infarct volumes were determined using triphenyltetrazolium chloride (TTC) staining technique.

  Results: Animals in sham operated group had normal motor function and no ischemic lesions were observed in cortical or striatal regions. Occurring ischemia in ischemic control group that received vehicle produced considerable infarction in cortex (253±15mm³) and striatum (92±7mm³), as well as these animals had sever impaired motor dysfunctions. Blocking of AT1 receptors with candesartan (0.1mg/kg or 0.5mg/kg) improved neurological outcome and significantly lowered cortical and striatal infarct volumes relative to ischemic control group.

  Conclusion: The findings of the present study indicated that stimulation of AT1 receptors by Ang II involved in ischemia/reperfusion injuries and blocking of AT1 receptors can decrease ischemic brain injury and improve neurological outcome.

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  Background & objectives: This study evaluated the effect of intravenous magnesium sulphate on clinical improvement of the patients with acute stroke. There is a lot of information about the use of magnesium sulphate in different conditions of brain ischemia while the effect of magnesium sulphate as a neuroprotective agent has been demonstrated in focal and global brain ischemiain animal models. However, the effect of this agent is still unclear.

  Methods: 80 patients (47 % female and 53 % male) with acute ischemic stroke signs and symptoms, lasting less than 12 hours of ischemia, were included in the study. Patients were divided into two groups 40 patients received 4 g of MgSO ₄ over 15 minutes and then 16 g over the next 24 hours, and the other 40 patients received serum normal salin as the placebo.

  Results: The results showed that magnesium sulphate administrated group had better clinical improvement rate than control group. The number of patients with grade III decreased in magnesium received group and patients with grade II, I were increased. After 2 weeks, patients with Grade IIIdecreased to 12.5% and the patients with grade II and I increased to 50% and 37.5%, respectively(based on NIHSS score).

  Conclusion: According to this study,magnesiumsulphatecan be used as a neuroprotective agent in patients with acute stroke.

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Background & objectives: Stroke is third leading cause of death and disability in the most of human communities. The use of herbs and medicinal plants in different countries is increasing. Today, herbal medicine is used as alternative or complementary therapies with a fewer side effects. Nigella sativa has a rich medical and religious history. Oxidative stress has important role in the pathophysiology of stroke. As Nigella sativa has antioxidant effects, its administration may produce a protective effect against complications of this disease. We examined the effects of the treatment with Nigella sativa oil on the cerebral infarction and edema.

Methods: 48 Male Sprague-Dawley rats were divided into three groups, sham, control ischemic and Nigella sativa oil treated (2 ml/kg) ischemic groups. Transient focal cerebral ischemia was induced by 90-min-long occlusion of the left middle cerebral artery followed by 24-h-long reperfusion. Neurological deficit score was evaluated at the end of the reperfusion period. Thereafter, the animals were randomly selected and used for two projects: (i) Measurement of the infarct volumes and neurological outcome (ii) investigation of ischemic brain edema formation using a wet/dry method.

Results: Induction of cerebral ischemia in the control group produced considerable brain infarction in conjunction with impaired motor functions and severely brain edema. Treatment with Nigella sativa oil significantly reduced the infarct volume and improved the motor functions. The water content in the left (lesioned) hemisphere was considerably elevated in the control ischemic group. Administration of the Nigella sativa oil significantly lowered the water content in the ischemic lesioned hemisphere.

Conclusion: Treatment with Nigella sativa oil can noticeably decrease the ischemic brain injury, attenuate edema formation and improve motor disabilities.

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Background & objectives: Basic and clinical studies have shown that the production of free radicals was one of the main factors leading to the injury after stroke. In this study we investigated the effect of hydroalcoholic extracts of Origanum vulgare on infarct volume and neurological deficits in a rat stroke model.

Methods: In this experimental study 35 male Wistar rats were randomly divided into 5 groups, each containing 7 animals. First group (control) received distilled water, while other three treatment groups received oral Origanum vulgare extract by gavage for 30 days (50, 75 and 100 mg/kg/day, respectively). These groups were subjected to 60 min middle cerebral artery occlusion 2 hours after the last dose of Origanum extracts and followed by 24 hrs reperfusion. After 24 hrs, the infarct volume and neurologic deficits were evaluated in the groups. Sham operated groups (n=7) did not receive Marjoram and brain ischemia.

Results: The hydroalcoholic extract of Origanum reduced the infarct volume and neurologic deficits in all treatment groups compared to control group.

Conclusion: It seems that Origanum vulgare extract can exert the neuroprotective effect against stroke damage by reducing infarct volume and neurological disorders.

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Background & objectives: Stroke is third leading cause of death and disability in the most of human communities. Several experimental studies have shown that combination therapy with drugs that act via different mechanisms can produce amplified protective effects. We examined the effects of combination therapy with candesartan and alpha tocopherol against cerebral ischemia.

Methods: Male Sprague-Dawley rats were divided into five groups (n=24): sham, control ischemic, candesartan treated (0.3 mg/kg), alpha tocopherol treated (30 mg/kg) and combined treated ischemic groups. Transient focal cerebral ischemia was induced by 90-min-long occlusion of the left middle cerebral artery followed by 24-h-long reperfusion. Neurological deficit score was evaluated at the end of the reperfusion period. Thereafter, the animals were randomly used for measurement of the infarct volumes and investigation of ischemic brain edema formation using a wet/dry method.

Results: Induction of cerebral ischemia produced considerable brain infarction in conjunction with severely impaired motor functions and edema formation. Combined treatment with candesartan and alpha tocopherol significantly reduced the infarct volume and lowered the water content in the ischemic lesioned hemisphere. These effects on brain edema and oxidative stress biomarkers were significantly more than the monotherapy with candesartan.

Conclusion: The combination therapy with candesartan and alpha tocopherol can noticeably decrease ischemic brain injury and attenuate edema formation likely via increasing the antioxidant activity.

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Background & objectives: Ischemic stroke has complex pathophysiology and its treatment with single neuroprotective drugs has so far failed. Combination therapy could produce amplified protective effects via different mechanisms. We examined the neuroprotective effects of enalapril and/or alpha tocopherol against sensorimotor dysfunctions of ischemic stroke.

Methods: Forty male Sprague-Dawley rats were randomly divided into five groups (n=8): sham, control ischemic, enalapril (0.03 mg/kg), alpha tocopherol (30mg/kg) and enalapril plus alpha tocopherol treated groups. Transient focal cerebral ischemia (90 min) was induced by occlusion of the left middle cerebral artery that followed by 24 h reperfusion periods. Infarct volumes were detected by TTC coloring technique and sensorimotor dysfunctions investigated by rotarod, grip strength and hotplate tests.

Results: Induction of cerebral ischemia in the control group produced severe neurological sensorimotor deficits in conjunction with considerable cerebral infarctions. Compared with the enalapril or alpha tocopherol groups, the combined treatment significantly improved neurological motor and sensory functions (p=0.038 and p=0.034, respectively) and also reduced the infarct volume (p=0.032).

Conclusion: Administration of alpha tocopherol increased protective effects of enalapril. Enalapril combined with alpha tocopherol can produce an augmented protection against ischemic brain injury, and improvement in sensorimotor dysfunctions.

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Background & objectives: Stroke is one of the most common causes of death worldwide and has distinctive features. Moreover, the different types of strokes are characterized by different physiopathological mechanisms. In the present study, we aimed to investigate the serum levels of ATG5 and apo B-48 and their diagnostic value in patients with ischemic stroke.
Methods: We selected 100 participants, including 50 ischemic stroke patients (22 women and 28 men) as the case group and 50 healthy individuals (23 women and 27 men) as the control group. Then, we conducted a case-control study in Imam Reza Hospital (Tabriz, Iran) from March 2016 to April 2016. Serum levels of ATG 5 and Apo B-48 were measured in both groups. We also evaluated the additional diagnostic value of these factors in both groups using receptor-related power analysis (ROC).
Results: The mean serum levels of ATG 5 and apo B-48 were significantly higher in the case group than in the control group (p<0.0001). The values under the ROC curve (AUC) for ATG5 and apo B-48 were 0.96 and 0.91, respectively. The area under the ROC curve indicates that ATG 5 and apo B 48 are appropriate biomarkers for diagnosing ischemic stroke.
Conclusion: Serum levels of ATG 5 and apo B -48 are significantly higher in patients with ischemic stroke than in healthy individuals and may be considered diagnostic biomarkers in patients with ischemic stroke.