الفهرس 
Arterial Blood Supply of BrainOnly 14 pages are availabe for public view
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Abstract
Background: Stroke remains a major global health problem with a significant increase in stroke burden in the world over the last two decades. Little is known about the association between homocysteine (Hcy) and intracranial or extracranial stenosis and is asymptomatic (carotid artery stenosis) CAS in the healthy population. Hcy is an independent indicator of asymptomatic CAS. So we aim to assess the serum level of the homocystiene as a risk factor in patients with ischemic stroke weather with extracranial or intracranial arterial stenosis and to compare the serum level of the homocystiene in patients with extracranial arterial stenosis against intracranial arterial stenosis and if there is a relation between Hcy serum level and degree of stenosis.
Patients and methods: Sixty ischemic stroke patients will be recruited either admitted to the stroke unit or showing up in the outpatient clinics and their assessment through carotid duplex or CT angiography or MR angiography, full labs and Hcy serum level with ELISA kits commercially available., Thirty healthy, age-matched and sex-matched individuals were enrolled in this study as a control group with Hcy serum level with ELISA kits commercially available.
Results: It was found high serum level of homocysteine is associated with increased risk of intracranial and extracranial arterial stenosis. Homocysteine remained independent risk factors for stenosis risk factors. The cut off value of Hcy level to discriminate between cases and controls was ≥ 16, with 43% sensitivity and 100% specificity. Also homocysteine serum level was found to be significantly high in male patients group. In addition Hcy serum level was significant with cases with past history of stroke or transient ischemic attacks (TIA).
Conclusion: Homocystiene serum level could be used to discriminate between cases and controls at at a cutoff level ≥16, with 43% sensitivity and 100% specificity. However according level, there was no significant correlation between Homocysteine level and degree or site of stenosis. So Hcy serum level can be done in for suspected patients of stenosis.