Correlation between Red Cell Distribution Width and Severity of Ischemic Cerebrovascular Stroke

Ischemic cerebrovascular stroke constitutes the majority of stroke burden worldwide and remains a leading cause of mortality and long-term disability. Despite advances in neuroimaging and reperfusion therapies, early identification of individuals at increased risk remains a major clinical challenge. Red cell distribution width (RDW), a routinely reported parameter in complete blood count, reflects variability in erythrocyte size and has emerged as a novel biomarker associated with adverse cardiovascular and cerebrovascular outcomes. Elevated RDW has been linked to systemic inflammation, oxidative stress, endothelial dysfunction, altered blood rheology, and prothrombotic states—key mechanisms implicated in ischemic stroke pathogenesis. This review examines the association between elevated RDW levels and ischemic stroke, synthesizing epidemiological evidence, exploring biological mechanisms, and evaluating clinical implications. Particular emphasis is placed on the relevance of RDW as a cost-effective biomarker in resource-limited settings such as South Gujarat. The potential role of RDW in stroke risk stratification and future research directions is discussed.