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Stroke

Case study on stroke for paramedic school

04/25/2005

Question:

i was wondering if there is a coorilation between elevated troponin and elevated creatinine when dealing with stokes and if it can effect kidney functions from prevous stokes. causing seizure activity. my pt had a hx of stokes and while transport to ED pt went into seizure activity and come to find out that his troponin and creatinine levels were elevated but there was no cardiac events.

Answer:

There is no known correlation between strokes and elevated creatinine (i.e. strokes don't cause renal dysfunction).  If one has severe atherosclerosis, hypertension, and diabetes, then one will have high risk for stroke and cardiac events; these risk factors are commonly associated with renal dysfunction.  If you have renal dysfunction, I believe that you can have false elevation of troponins (but didn't look this one up).

I suspect that your patient had a stroke (or strokes) that involved the cortex of the brain, and thus had a reason to have seizures.  Thereafter, it can be very difficult to tell if a patient is having another stroke or a seizure (or sometimes both).  I suspect that the elevated creatinine was simply associated with risk factors and that elevated troponin associated with renal dysfunction.

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Response by:

Brett   Kissela, MD Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati