Blood homocysteine levels in stroke patients undergoing rehabilitation

One of the major concerns of a stroke victim is the threatening possibility of loosing all the functional achievements attained through prolonged rehabilitation effort, in case of a recurrent cerebrovascular event. Recently, elevated serum homocysteine (Hcy) level was found to be associated with an increased risk for atherosclerotic vascular disease. The aim of the present study was to assess the yield of screening stroke patients for hyperhomocysteinemia, as part of the measures taken to reduce the risk of stroke recurrence.

Blood Hcy levels of stroke patients undergoing rehabilitation were compared to the Hcy levels of patients admitted for rehabilitation following brain damage of non-vascular etiologies.

The mean Hcy level was found to be significantly higher in the former group (10.21+/-7.81 micromol/L and 6.16+/-4.28 micromol/L in the stroke group and in the non-vascular group, respectively [p<0.003]). However, when analysis of variance was applied and the correlation with age was accounted for, the difference between the groups became insignificant.

Considering the current high cost of blood Hcy tests, the above findings do not support adoption of an overall, non-selective screening policy for hyperhomocysteinemia in stroke patients. However, it may be justified to measure Hcy levels, as well as folic acid, vitamin B6 and vitamin B12 levels, in selected stroke cases. Further study is needed in order to set clear guidelines for the search after this possible risk factor of stroke, one of the major causes of morbidity and mortality in modern society.