TITLE:
Evaluation of Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet Indices in Acute Ischemic Stroke: An Experience of a Tertiary Care Hospital
AUTHORS:
Anshu Gupta, Tanima Dwivedi
KEYWORDS:
Neutrophil to Lymphocyte Ratio, Platelet Indices, Stroke, Emergency Service
JOURNAL NAME:
Open Journal of Pathology,
Vol.16 No.4,
October
23,
2026
ABSTRACT: Stroke is one of the leading causes of death and disability in India and across the world. Inflammatory cells, particularly neutrophils, play a major role in the pathogenesis of stroke by contributing to blood-brain barrier disruption, cerebral edema, and subsequent brain injury, and targeting these cells may help reduce infarct size and improve outcomes. In contrast, lymphocyte levels tend to decrease after an acute ischemic stroke (AIS), making the neutrophil-to-lymphocyte ratio (NLR) a simple, low-cost, and reliable inflammatory marker that reflects the body’s response, with elevated levels commonly observed after a stroke. Platelets also participate in the development of intravascular thrombosis, and their size reflects their activity, which can be assessed through platelet indices (PI) such as mean platelet volume (MPV), platelet large cell ratio (P-LCR), platelet distribution width (PDW), and plateletcrit (PCT). With this background, the study aimed to evaluate the presence of an inflammatory state in stroke patients using NLR values and to assess the relationship between different platelet indices and AIS. This prospective study included 145 AIS patients admitted to the emergency department of a tertiary neurosciences hospital and compared them with an equally sized group of age- and sex-matched healthy individuals. The results showed that NLR and various platelet indices were significantly higher in AIS patients, indicating that these easily measurable parameters effectively reflect inflammation and platelet activity in individuals with acute ischemic stroke.