title: Acute-phase vitamin B12 and folic acid levels in patients with ischemic and hemorrhagic stroke: is there a relationship with prognosis?
abstract: OBJECTIVE
  The aim of this study was to investigate blood folic acid and vitamin B12 levels in patients with ischemic and hemorrhagic stroke patients and correlate these levels with prognosis.
  
  
  METHODS
  Patients presenting within 3 hours of onset of ischemic or hemorrhagic strokes were approached for participation in the study. Diagnosis was made by clinical examination and head computed tomography scan. Venous blood samples were taken for determination of blood folic acid and vitamin B12 levels. Parameters were evaluated with respect to stroke type and according to Glasgow coma scale (< or =8 or > or =9).
  
  
  RESULTS
  Eighty-seven patients with ischemic stroke (mean age: 65 +/- 10 years, 53% male) and 27 patients with hemorrhagic stroke (mean age: 60 +/- 10 years, 56% male) were included in the study. A significant direct correlation was found between Glasgow coma scale and mean plasma B12 levels in ischemic, but not hemorrhagic, stroke (r=112.75 and p=0.007, respectively). A significant direct correlation was found between Glasgow coma scale and mean plasma folic acid levels in hemorrhagic, but not ischemic, stroke (r=1.03 and p=0.017, respectively). In patients with Glasgow coma scale < or =8 (either hemorrhagic or ischemic stroke), a significant direct correlation was found between Glasgow coma scale and blood vitamin B12 levels. Vitamin B12 levels were significantly lower in patients with Glasgow coma scale < or =8 than in patients with Glasgow coma score > or =9 (p=0.04).
  
  
  CONCLUSIONS
  In patients with ischemic stroke, low vitamin B12 levels, and in patients with hemorrhagic stroke, low blood folic acid levels, are associated with lower Glasgow coma scale values and higher hospital mortality.
authors.affiliation: Department of Emergency Medicine, Meram Faculty of Medicine, Selçuk University, Meram, Konya 42080, Turkey. aysegulbayir@hotmail.com
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Bayir
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ak
authors.forename: Serife
authors.initials: S
authors.lastname: Ozdinç
authors.forename: Abdüsselam
authors.initials: A
authors.lastname: Seydanoğlu
authors.forename: Senol Kadir
authors.initials: SK
authors.lastname: Köstekçi
authors.forename: Fatih
authors.initials: F
authors.lastname: Kara
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D005492:Folic Acid / Q000097:blood*; D015600:Glasgow Coma Scale / Q000639:trends; D006801:Humans; D020300:Intracranial Hemorrhages / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D013997:Time Factors; D014805:Vitamin B 12 / Q000097:blood*
chemical_list: D015415:Biomarkers; D005492:Folic Acid; D014805:Vitamin B 12