Developing country like India is facing a double burden of communicable and noncommunicable diseases. Ischemic stroke is a heterogeneous disorder with multiple etiological mechanisms. Large artery atherosclerotic disease of both intracranial and extracranial arteries is one of the main cause of ischemic stroke disease. A Cross-sectional study was done in 90 patients in Saveetha Medical College Hospital analyzing the clinical features, risk factors and distribution of large artery disease in patients with ischemic stroke. Patient underwent clinical examination, information regarding demographic profile, risk factors of stroke were collected, blood investigations including complete blood count, blood glucose, renal and liver function, lipid profile and electrolytes were done. Each patient underwent magnetic resonance imaging (MRI) of brain with MRA. Out of 90 patients 73 had middle cerebral artery occlusion, 2 had anterior cerebral artery occlusion, and 15 had posterior cerebral artery occlusion. 71 patients (78.9%) had hemiplegia, 34 (37.77%) patients had speech involvement, 42 (46.66%) had giddiness, and 28 (31.1%) had altered sensorium. Headache was present in 25 (27.77%) patients, and 35 (38.88%) had visual disturbances. The site of extracranial occlusion was determined using Carotid Doppler. Among the 2 patients who had ACA occlusion, 1 had occlusion at the level of CCA and 1 at carotid bulb. Among the 15 patients who had PCA occlusion, 1 had CCA occlusion and 3 had occlusion at the level of carotid bulb. 73 patients who had MCA occlusion had 7 CCA occlusion, 16 ICA occlusion, 14 carotid bulb occlusion and 28 ICA and CCA combined occlusion. MCA occlusion is commonest among the intracranial artery occlusion and when MCA is involved majority of patients have extracranial involvement (CCA/ICA/ carotid bulb) pointing to the fact that extracranial occlusion is almost invariable present when the MCA infarct is present.

Keywords: Stroke; Large artery occlusion; Extracranial occlusion; Intracranial stenosis.