Acute Ischemic Stroke Involves Significant Inflammatory Response. This Prospective Cohort Study Evaluates the Predictive Value of Monocyte-, Neutrophil-, and Leukocyte-to-albumin Ratios for Stroke Severity and Functional Outcome Using NIHSS at Admission and Modified Rankin Scale During Follow-up.

Inclusion criteria

• Adult patients (≥ 18 years old) admitted with a diagnosis of acute ischemic stroke confirmed by brain imaging (CT or MRI).
• Admission within a defined time window from stroke onset (e.g., within 48 hours) to capture acute inflammatory response.
• Availability of complete blood count (CBC) with differential and serum -albumin levels at admission.
• Informed consent obtained from the patient or their legal representative.

Exclusion criteria

• Patients with hemorrhagic stroke or transient ischemic attack (TIA).
• Patients with previous history of ischemic stroke.
• Patients who accepted intravenous thrombolysis (IV tPA) and or mechanical thrombectomy.
• Pre-existing inflammatory or autoimmune diseases (e.g., rheumatoid arthritis, lupus, inflammatory bowel disease) that could influence monocyte count or albumin levels.
• Active infections (bacterial, viral, fungal) at admission.
• Severe liver or kidney disease affecting albumin synthesis or catabolism.
• Hematological disorders affecting white blood cell counts. ⚫ Patients on immunosuppressive therapy or corticosteroids.
• Patients with known malignancy
• Lack of complete blood count (CBC) with differential and serum albumin levels at admission.
• Patients who received blood transfusions before blood sampling.
• Patients with other acute severe medical conditions that significantly impact inflammatory markers (e.g., sepsis, major trauma).