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Formation of free radicals and subsequent lipid peroxidation may have an important role in tissue injury and neuromal cell death after cerebral ischaemia.We conducted a prospective,controlled study to determine whether the endogenous antioxidant vitamins A and E had a protective function in acute ischaemic stroke.The study population consisted of 80 patients seen at the Free University Hospital in Brussels.Entry criteria were occurrence of sudden focal neurological deficit lasting more than 3h;deficit due to acute ischaemia in the territory of the middle cerebral artery;and investigation within 24h of onset of the episode.Outcome was assessed within the first 21 days.80 controls matched for age and sex had various neurological disorders other than ischaemia.Serum concentrations of vitamins A and E were similar in the study and control groups.In the study population a serum vitamin A concentration higher than the mean of 2 27 umol/l was associated with a higher frequency of complete recovery within the first 24h(p<0.05),decreased mortality(p=0.038),and a better outcome assessed by the Mathew scale of neurologic deficit(p<0.03)and the Barthel index.There was no significant difference in outcome between patients with vitamin E concentrations above or below the mean of 35.3umol/l.Our results suggest a beneficial effect of a high serum vitamin A concentration in early outcome in ischaemic strokes. |
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