The relationship of serum homocysteine, vitamin B12 and folic acid levels with stroke severity and infarct volume in elderly patients presenting to the emergency department with ischemic stroke

Objective: In our study, we aimed to evaluate the relationship of vitamin B12, folic acid and homocysteine with stroke severity, infarct volume and prognosis in patients aged 65 and over who presented with acute ischemic stroke. Method: Our study was planned as a prospective, observational and descriptive study. 80 patients who applied to the Emergency Department of KTU Medical Faculty Hospital with stroke symptoms were included in the study. For the control group, 80 participants of similar age and gender without a history of ischemic stroke were selected. During their follow-up in the emergency department, brain and diffusion MR imaging were performed and blood samples were taken for serum homocysteine, folic acid and vitamin B12. NIHSS was used to evaluate the severity of stroke at the time of admission, and for prognostic evaluation, the need for intensive care in the emergency department follow-up and the MRS score and mortality at the end of the 3-month follow-up were evaluated. Infarct volumes were calculated by an experienced neuroradiologist. IBM SPSS.25 program was used in all analyzes. Results: In our study, no difference was found between the patient and control groups in terms of homocysteine, vitamin B12 and folic acid values. In addition, when the relationship of homocysteine, vitamin B12 and folic acid with infarct volume, development of clinical need for intensive care, NIHSS score, MRS score and development of mortality in the 3-month period was evaluated, only homocysteine was associated with the development of mortality in the 3-month period, and folic acid with the MRS score. Conclusion: In our study, the effect of homocysteine, vitamin B12 and folic acid values on stroke severity and infarct volume could not be clearly demonstrated. More extensive studies should be done on this subject. Keywords: Homocysteine, acute ischemic stroke, infarct volume