| Predictive role of modified clinical diffusion mismatch in early neurological deterioration due to atherothrombotic ischemia in the anterior circulation. | |
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MedLine Citation:
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PMID: 21751012 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Atherothrombotic ischemia is the most frequent cause of cerebral ischemia; however, few reports have addressed the prognostic factors predicting early neurological deterioration (END) when the occlusive lesion is limited to the anterior main trunk, middle cerebral artery (MCA) or internal cerebral artery (ICA). METHOD: Between 2006 and 2008, 122 atherothrombotic ischemia patients were diagnosed with MCA or ICA occlusive disease on magnetic resonance angiography. The National Institutes of Health Stroke Scale (NIHSS) score and the modified Alberta Stroke Program Early CT Score on diffusion-weighted imaging [ASPECTS-DW (modified)] were calculated. Clinical-DWI mismatch (CDM) was evaluated using NIHSS and the ASPECTS-DW (modified) to examine the predictive efficacy for early neurological deterioration. RESULTS: Eighteen of 122 (14.8%) patients fulfilled the definition of CDM. END was observed in 24 patients (19.7%) within 15 days after admission. CDM was observed in 14 cases in the END (+) group (14 of 24 cases, 58.3%) and 4 cases in the END (-) group (4 of 98 cases, 4.1%) (p = 0.001). Multivariate logistic regression analysis demonstrated that CDM was a significant predictive factor of END (odds ratio 26.68, p = 0.0001). CONCLUSIONS: CDM based on NIHSS and ASPECTS-DW (modified) could be a significant predictive factor for END of atherothrombotic ischemia in MCA/ICA. |
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Authors:
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Atsushi Saito; Hiroaki Shimizu; Miki Fujimura; Takashi Inoue; Teiji Tominaga |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-7-13 |
Journal Detail:
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Title: Acta neurochirurgica Volume: - ISSN: 0942-0940 ISO Abbreviation: - Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-7-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0151000 Medline TA: Acta Neurochir (Wien) Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Neurosurgery, Kohnan Hospital, 4-20-1 Nagamachiminami, Taihaku, Sendai, Miyagi, 982-8523, Japan, satsushi2002@yahoo.co.jp. |
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