| Prognostic value of CT angiography in patients with suspected vertebrobasilar ischemia. | |
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MedLine Citation:
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PMID: 18190495 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The outcome of vertebrobasilar ischemia depends on the clinical presentation and the presence or absence of vascular occlusion. The aim of our study was to analyze the CT angiography (CTA) predictors of outcome in patients with suspected vertebrobasilar ischemia. METHODS: We studied patients with suspected acute vertebrobasilar ischemia between April 2002 and January 2006 and had CTA done within 24 hours of symptom onset. We reviewed the final diagnosis and 3-month follow-up and analyzed the clinical and CTA predictors of outcome. RESULTS: Of the 133 patients, 21(15%), 18 (13%), and 16 (12%) had occlusion of basilar artery (BA), vertebral artery (VA), and posterior cerebral artery (PCA) respectively. The final diagnosis was stroke in 98 (73.6%), transient ischemic attack (TIA) in 10 (7.5%), and nonischemic in 25 (18.8%). No vascular occlusion was seen on CTA in patients with TIA and nonischemic diagnosis. At 3-month follow-up, we found a mortality rate of 10.6% and good functional outcome in 71.4%. The predictors of death in the multivariable analysis were the presence of BA occlusion (odds ratio[OR] 6.7, 95% CI, 1.4-30.6) and baseline National Institutes of Health Stroke Scale (NIHSS) (OR 1.14, 95% CI, 1.06-1.2). When patients with basilar occlusion were excluded, the presence of VA occlusion (OR 6.5, 95% CI, 1.34-31.4), age (OR 1.09, 95% CI, 1.03-1.14), and baseline NIHSS (OR 1.1, 95% CI, 1.03-1.18) predicted poorer outcome. CONCLUSIONS: The presence or absence of a vascular occlusion is a critical factor for prognosis in suspected acute vertebrobasilar ischemia and is correlated with the location of occlusion. |
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Authors:
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P N Sylaja; Volker Puetz; Imanuel Dzialowski; Andrea Krol; Michael D Hill; Andrew M Demchuk |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of neuroimaging : official journal of the American Society of Neuroimaging Volume: 18 ISSN: 1051-2284 ISO Abbreviation: J Neuroimaging Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2008-01-14 Completed Date: 2008-04-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102705 Medline TA: J Neuroimaging Country: United States |
Other Details:
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Languages: eng Pagination: 46-9 Citation Subset: IM |
Affiliation:
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Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Basilar Artery* Brain Ischemia / physiopathology, radiography* Cerebral Angiography Chi-Square Distribution Female Humans Logistic Models Male Middle Aged Predictive Value of Tests Prognosis Tomography, X-Ray Computed Vertebral Artery* |
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