Predictive role of modified clinical diffusion mismatch in early neurological deterioration due to atherothrombotic ischemia in the anterior circulation

Atsushi Saito, Hiroaki Shimizu, Miki Fujimura, Takashi Inoue, Teiji Tominaga

研究成果: Article査読

1 被引用数 (Scopus)

抄録

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.

本文言語English
ページ(範囲)2205-2210
ページ数6
ジャーナルActa neurochirurgica
153
11
DOI
出版ステータスPublished - 2011 11月

ASJC Scopus subject areas

  • 外科
  • 臨床神経学

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