الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Cerebrovascular stroke is a heterogeneous disorder with different pathogenic mechanisms as intracerebral hemorrhage, atherothrombotic brain infarct, and cardiac emboli. Ischemic strokes are the main category of stroke, accounting for more than 80% of all cerebrovascular events in people aged more than 70 years. Stroke is the second leading cause of mortality worldwide and the third most common cause of death in the industrialized world after heart disease and all types of cancer combined.
Atherosclerosis of extracranial and intracranial arteries accounts for approximately two thirds of all ischemic strokes. Signs of chronic inflammation are present throughout the different stages of atherosclerosis. During the inflammatory reaction, pro-inflammatory and anti-inflammatory cytokines are produced and tend to modulate the inflammatory process. With the recognition that atherosclerosis is an inflammatory process, several plasma markers of inflammation as serum albumin level and C-reactive protein(CRP) have been evaluated as potential tools for prediction of the risk of vascular events.
Albumin is an important protein in the blood for maintaining normal permeability of the microvessel wall, inhibiting platelets aggregation, and reducing blood viscosity. Serum albumin levels are inversely associated with myocardial infarction, atrial fibrillation, cardiovascular diseases, and death.
There has been increasing interest in the association between serum albumin levels and stroke in recent years. Several studies have suggested an inverse association between albumin concentrations and stroke risk. The underlying pathophysiology , however, remains unclear. Ischemic stroke is a syndrome with heterogenous causes, including cardiac embolism, large artery atherosclerosis, and small vessel diseases.
This study was undertaken to prove that clinical hypoalbuminemia (Serum Albumin below 3.5 g/dl) and subclinical hypoalbuminemia (Serum Albumin below 3.9 g/dl) have a correlation with the severity and outcome for all types of ischemic cerebrovascular strokes. And its relation to serum fibrinogen and CRP.
This study is case-control study was conducted on 156 patients in Alexandria main university hospital and Nariman hospital from June 2014 to January 2015. Participants classified into two groups ( 96 patients admitted with acute ischemic cerebrovascular stroke + 60 control participants from neuropsychiatry clinic and ICU patients ). All participants undergo medical history and blood sampling. Stroke patients assessed by ( National Institutes of Health Stroke Scale ) to eastimate the severity of stroke and ( Modified Rankin Scale ) to evaluate the outcome.
In our study we have found a significant difference in serum albumin level between group A (cases) and group B (control). The mean albumin level in group A was 3.31± 0.54 g/dl, but it was 3.97± 0.47 g/dl in group B. Also we have found a significant difference in CRP level between two groups, its mean was 37.86± 43.34 mg/l in group A and 12.69± 18.15 mg/l in group B. There was a negative correlation between serum albumin level and (CRP, fibrinogen, NIHSS, mRS) (P ≤ 0.05). There was a high negative correlation between serum albumin level and (CRP, NIHSS, mRS). Mild negative correlation between serum albumin level and fibrinogen. No significant relation between serum fibrinogen level and (NIHSS, mRC). Mild positive