Browsing by Author "Somaratne, K.G.S.K."

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    Case Report: Dengue hemorrhagic fever with ischemic stroke.
    (American Society of Tropical Medicine and Hygiene, 2022) Basnayake, B.W.M.K.E.; Somaratne, K.G.S.K.; Goonetilleke, C.U.; Tilakaratna, P.M.Y.I.; Ranawaka, U.K.
    Several neurological manifestations are recognized in dengue infection, but stroke is a rare complication. We report a case of ischemic stroke in a patient with dengue hemorrhagic fever. A 52-year-old previously healthy male presented with a history of fever for 2 days, and left-sided weakness and numbness of sudden onset. MRI scanning showed a right-sided thalamic lacunar infarct. Diagnosis of dengue fever was made based on leuco-thrombocytopenia, positive dengue nonstructural protein-1 (NS-1) antigen, and positive dengue IgM antibodies. Severity of limb weakness correlated with the critical phase of dengue hemorrhagic fever (DHF). He was discharged home with good recovery from neurological symptoms and disability. Strokes are rare in dengue, and are mainly hemorrhagic strokes related to thrombocytopenia. Ischemic stroke is even rarer. More evidence is needed for confirmation of dengue as a pathogenic mechanism of ischemic stroke.
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    Spontaneous intracerebral haemorrhages from a Sri Lankan tertiary care center: 5-year data
    (Ceylon College of Physicians, 2021) Dep, W.D.C.; Deelaka, A.G.S.; Somaratne, K.G.S.K.; Meegahapola, H.; Premadasa, H.M.S.D.; Kurukulasuriya, S.A.F.; Mettananda, K.C.D.; Ranawaka, U.K.
    Introduction and Objectives Epidemiological data on spontaneous intracerebral haemorrhage (sICH) is limited from South Asia. We sought to describe epidemiology of sICH in a Sri Lankan cohort. Methods We studied all patients with stroke admitted to the Stroke Unit, Colombo North Teaching Hospital over five years. Data from sICH patients regarding treatment seeking delays, clinical char-jcteristics, risk factors, stroke severity and functional outcome were compared with ischa-mic stroke (IS) patients. Resists 984 patients (mean age 58.7 years; 62.1% males) were studied: sICH 15.0% (147 patients), IS 85.0%. sICH patients: mean age 58.0 years; 67.3% males. sICH patients presented to hospital earlier (<3h sICH 70.6%, IS 37.2%, p<0.001) and had more severe strokes (NIHSS>15) (sICH 21.3%, IS 12.2%; p<0.001). Hypertension was commoner in sICH group (sICH 72.6%, IS 63.5%; p=0.034), whereas diabetes (sICH 39.0%, IS 51.6%; p=0.005) and smoking (sICH 16.6%, IS 25.5%; p=0.021) were less common. Altered consciousness (sICH 30.3%, IS 18.3%; p=0.001), dysphagia (sICH 55.9%, IS 34.4%; p<0.001), bladder involvement (sICH 56.6%, IS 28.7%; p<0.001), and seizures (sICH 4.1%, IS 1.5%; p=0.029) were commoner among sICH patients. sICH patients had more severe disability on discharge (Barthel index 0-60: sICH 71.1%, IS 45.2%; p<0.001; modified Rankin scale (mRS) 3-6: sICH 76.7%, IS 52.1%; p<0.001). sICH location (lobar vs. deep) and presence of intraventricular haemorrhage was not associated with stroke severity. Lobar ICHs had more severe disability on discharge (Barthel index <60: p=0.037; mRS>3: p=0.020). On logistic regression, sICH was independently associated with early presentation to hospital (OR 1.79; p=0.039), and severe disability on discharge (Barthel index <60: OR 2.42, p=0.028; mRS>3: OR 2.70, p=0.012). Conclusions sICH patients sought medical attention early and had different clinical profiles, more severe strokes and more severe disabilities.