LÂM SÀNG, CẬN LÂM SÀNG Ở NGƯỜI BỆNH NHỒI MÁU NÃO CẤP CÓ ĐÁI THÁO ĐƯỜNG TÝP 2

Abstract

Objective: To describe the clinical and paraclinical characteristics of patients with acute ischemic stroke in type 2 diabetes mellitus. Subjects and Methods: We prospectively enrolled 100 patients with acute ischemic stroke, including 50 with type 2 diabetes mellitus, who were treated at the Neurology Center, Bach Mai Hospital, from January 2023 to May 2025. Results: The mean age was 64.9 ± 9.1 years. NIHSS scores were moderate (5–15) in 72% of cases, mild (0–4) in 18%, and severe (>16) in 10%. The clinical manifestations of lacunar infarction were pure motor hemiparesis (38.5%) and sensorimotor hemiparesis (26.9%), followed by dysarthria–clumsy hand syndrome (11.6%) and hemiataxia (3.8%). The mean admission blood glucose was 12.25 ± 5.83 mmol/L. Overall, 72% of patients had HbA1C ≥ 7, with a mean HbA1C of 8.56 ± 2.89, and 60% had hypercholesterolemia. Carotid atherosclerosis with <70% stenosis was more frequent in the diabetic group than in the non-diabetic group (60% vs. 36%, p<0.05). Brain MRI showed multiple lacunar infarctions in 71.4% of patients, most commonly in the basal ganglia and internal capsule (42.9%), followed by the brainstem and cerebellum (25.7%), corona radiata and centrum semiovale (17.1%), and thalamus (14.3%). Conclusion: Patients with type 2 diabetes mellitus who developed acute ischemic stroke most commonly had moderate NIHSS scores, frequently presented with metabolic disorders, and often exhibited multiple lacunar infarctions.