DEMOGRAPHIC , CLNICAL  AND IMAGING  PROFILE , ETIOLOGIC CLASSIFICATION, MANAGEMENT STRATEGIES AND OUTCOMES OF STROKES IN ELDERLY ( 80 YEARS AND ABOVE) - A FIVE YEAR RETROSPECTIVE STUDY
Rimpy Joseph, Venugopalan Y Vishnu, Rohit Bhatia, Sahil Kohli, Ayush Agarwal, Vasantha Padma

Introduction  : Age is the most important non-modifiable risk factor for all stroke subtypes & patient outcomes are greatly influenced by age. 

Patients and methods : Retrospective review of data collected from admission, discharge and death registers along with detailed analysis of case summaries obtained from Computerised Patient Record System (CPRS) at AIIMS during the time period 2014-2018. 

Results : A total of 105 patients with strokes in elderly (>80 yrs) were admitted during the study period. The mean age at presentation was 81.69 years (Ischemic, 82.11 and hemorrhagic 83.32 yrs).  Ischemic strokes constituted 61 (75.24% ) while hemorrhagic strokes accounted for 21 (24.76% )of all strokes. 
The males in ischemic and hemorrhagic stroke were 50.63%% and 50% respectively. Risk factors were hypertension ( 81.01%), diabetes ( 35.44%), coronary artery disease (31.64%)  & atrial fibrillation ( 31.64%). Nineteen patients (24%) presented within the window period for thrombolysis of which fourteen underwent thrombolysis . Decompressive craniectomy was done in 2 patients and two patients underwent mechanical thrombectomy. The most frequent TOAST classification subtypes were Large artery atherosclerosis (37.97%), cardioembolic stroke (31.64% )and undetermined etiology ( 2 or more -30.37%). The mortality rate in ischemic and hemorrhagic stroke were 21/79 (26.58%) and  10/26 (38.46%) respectively.
More than 90% of hemorrhagic stroke patients were hypertensive. The most frequent location was gangliocapsular(63.63%). Two patients required hematoma evacuation and another two required EVD insertion.

Conclusion : Ischemic strokes constituted two-third of stroke in very elderly and 24 % received thrombolysis. In ICH the most common location was gangliocapsular and more than 90% had hypertension.

DEMOGRAPHIC ,CLINICAL AND IMAGING  PROFILE ,ETIOLOGIC CLASSIFICATION, MANAGEMENT STRATEGIES AND OUTCOMES OF STROKES IN ELDERLY (80 YEARS AND ABOVE)- A FIVE YEAR RETROSPECTIVE STUDY