الفهرس 
Def. & Classification of Ischemic StrokeOnly 14 pages are availabe for public view
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Abstract
Stroke is the second leading cause of death and one of the most frequent causes of disability worldwide.
Diagnosis of acute ischemic stroke (AIS) is difficult because computed tomography (CT) results may appear normal in the early stage and magnetic resonance imaging (MRI) is not always possible in golden time of treatment. Thus, many cases experience delays in receiving intravenous thrombol-ysis treatment and therefore poor clinical outcome and prognosis.
The use of specific biomarkers might aid stroke diagnosis and that approach might permit rapid referral of patients to stroke centers and early management.
One of these biomarkers is D-dimer, a fibrin degradation product released into the blood stream by fibrinolysis of cross-linked fibrin and indicating the presence of active thrombus formation and lysis.
We studied the D dimer level in a group of acute ischemic stroke patients and healthy persons, we found significant elevation of D dimer level among the AIS patients than the healthy persons. This means measurement of serum D-dimer level in patients with stroke can increase the sensitivity of cranial computed tomography to diagnose ischemic stroke and allowing rapid interference and treatment.
We found high levels of D-dimer in plasma were associated with the sever strokes defind by NIHSS score. In our study all patients had NIHSS less than 18 and we hope to apply this study on larger number of patients to include patients with larger scores.
We found that D- dimer level has good correlation with the volume of infarction area in the MRI imaging. We reached to D-dimer level correlated to the volume of the infarcted area roughly equal or larger than on third of middle cerebral artery territory this may be helpful in decicion of thrombolysis injection. we hope in the future this issue undergo more studies using more accurate methods of volumtery and try to find clear cut- off above which thrombolysis will not be recommended.
There was significant difference among stroke subtypes after an acute ischemic event as regard D-dimer levels, and patients with cardio-embolic events had significantly higher levels than patients with different etiologic factors. Low D-dimer levels in the first 24 hours make a cardio-embolic stroke unlikely, and may be useful to guide further investigations.
Our patients were followed for one month, D-dimer levels was significantly higher in patients of unfavourable out come than patients favourable out come group.
Normal D-dimer levels do not exclude brain infarction and elevated D-dimer levels do not substitute clinical or radiological examinations.