Skripsi

The effect of hemispheric lateralization upon neurological putcome among ischemic stroke patients.

Introduction: Stroke remains a serious health problem and is the third leading cause of mortality in the world. Evidence from studies assessing stroke outcome by side of involvement is inconclusive, thus justifying the importance of carrying out a study to investigate the difference in neurological outcome among patients with right (RHS) and left (LHS) hemispheric ischemic stroke. Methods: This study design was cross-sectional, being conducted for four months at RSCM. The accessible population was ischemic stroke patients admitted in Neurology Department of RSCM from 2006 to 2009. Hemispheric lateralization and neurological outcome were dichomatized and analyzed using Chi-square test. Mann- Whitney test was used for ordinal variables. A p-value of < 0.05 was considered significant. Results and Discussion: After applying inclusion and exclusion criteria, a total sample of 230 patients was included. Equal number of subjects (115 each) was found in both groups, by chance. Patients with LHS had significantly higher baseline median NIHSS scores compared with RHS patients (p = 0.018), which may be explained by the structural bias inherent in NIHSS itself. In contrast, there was greater percentage of RHS patients with hypertension in comparison to LHS patients (p = 0.043). While more patients with LHS had good neurological outcome compared with RHS patients, this difference did not reach statistical significance (p = 0.072). Conclusion: It can be concluded that there was no significant difference in neurological outcome between patients with acute RHS compared with those with LHS. In future trials, analyses of stroke outcome should adjust for baseline NIHSS scores and stroke hemispheric lateralization in order to minimize potential confounding factors.
Keywords: Ischemic stroke, Hemispheric lateralization, NIHSS, Outcome.