Perfusion and Diffusion Variables Predict Early Neurological Deterioration in Minor Stroke and Large Vessel Occlusion

Dong-Seok Gwak; Jung-A Kwon; Dong-Hyun Shim; Yong-Won Kim; Yang-Ha Hwang

추천

검색

자료유형: 학술저널

저자정보: Dong-Seok Gwak (Department of Neurology Kyungpook National University Hospital Daegu Korea) Jung-A Kwon (Department of Neurology Kyungpook National University Hospital Daegu Korea) Dong-Hyun Shim (Department of Neurology Kyungpook National University Hospital Daegu Korea) Yong-Won Kim (Department of Neurology Kyungpook National University Hospital Daegu Korea) Yang-Ha Hwang (Department of Neurology Kyungpook National University School of Medicine Daegu Korea)

저널정보: 대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중학회지 제23권 제1호

발행연도: 2021.1

수록면: 61 - 68 (8page)

이용수

📌

연구주제

📖

연구배경

🔬

연구방법

🏆

연구결과

초록· 키워드

오류제보하기

Background and Purpose: Patients with acute large vessel occlusion (LVO) presenting with mild stroke symptoms are at risk of early neurological deterioration (END). This study aimed to identify the optimal imaging variables for predicting END in this population. Methods: We retrospectively analyzed 94 patients from the prospectively maintained institutional stroke registry admitted between January 2011 and May 2019, presenting within 24 hours after onset, with a baseline National Institutes of Health Stroke Scale score ≤5 and anterior circulation LVO. Patients who underwent endovascular therapy before END were excluded. Volumes of Tmax delay (at>2, >4, >6, >8, and >10 seconds), mismatch (Tmax >4 seconds ? diffusion-weighted imaging [DWI] and Tmax >6 seconds ? DWI), and mild hypoperfusion lesions (Tmax 2?6 and 4?6 seconds) were measured. The association of each variable with END was examined using receiver operating characteristic curves. The variables with best predictive performance were dichotomized at the cutoff point maximizing Youden’s index and subsequently analyzed using multivariable logistic regression. Results: END occurred in 39.4% of the participants. The optimal variables were identified as Tmax>6 seconds, Tmax >6 seconds ? DWI, and Tmax 4?6 seconds with cut-off points of 53.73, 32.77,and 55.20 mL, respectively. These variables were independently associated with END (adjusted odds ratio [aOR], 12.78 [95% confidence interval (CI), 3.36 to 48.65]; aOR, 5.73 [95% CI, 2.04 to 16.08];and aOR, 9.13 [95% CI, 2.76 to 30.17], respectively). Conclusions: Tmax >6 seconds, Tmax >6 seconds ? DWI, and Tmax 4?6 seconds could identify patients at high risk of END following minor stroke due to LVO.

#Clinical deterioration #Magnetic resonance imaging #Stroke

참고문헌 (40)

참고문헌 신청

Heldner MR / 2013 / National Institutes of Health stroke scale score and vessel occlusion in 2152 patients with acute ischemic stroke / Stroke 44:1153~1157

Reeves M / 2013 / Distribution of national institutes of health stroke scale in the Cincinnati/Northern Kentucky stroke study / Stroke 44:3211~3213

Spokoyny I / 2015 / Defining mild stroke : outcomes analysis of treated and untreated mild stroke patients / J Stroke Cerebrovasc Dis 24:1276~1281

Khatri P / 2012 / Ninety-day outcome rates of a prospective cohort of consecutive patients with mild ischemic stroke / Stroke 43:560~562

Romano JG / 2015 / Outcomes in mild acute ischemic stroke treated with intravenous thrombolysis : a retrospective analysis of the Get With the Guidelines-Stroke registry / JAMA Neurol 72:423~431

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!