Progression of stroke deficits in patients presenting with mild symptoms: The underlying etiology determines outcome

Autor: Ashfaq Shuaib, Naveed Akhtar, Reny Francis, Abdul Salam, Lubna ElShiekh, Noha Mhjob, Faisal Wadiwala, Soha Al-Makki, Hisham Elkhider, Dirk Deleu, Musab Ali, Rola Khodair, Hassan AlHussain, Saadat Kamran
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Critical Care and Emergency Medicine
Time Factors
Etiology
medicine.medical_treatment
030204 cardiovascular system & hematology
Pathology and Laboratory Medicine
Vascular Medicine
Diagnostic Radiology
Brain Ischemia
0302 clinical medicine
Medicine and Health Sciences
Thrombolytic Therapy
Stroke
Tomography
Multidisciplinary
Radiology and Imaging
Thrombolysis
Middle Aged
Magnetic Resonance Imaging
Hospitals
Treatment Outcome
Neurology
Tissue Plasminogen Activator
Cardiology
Disease Progression
Medicine
Female
medicine.symptom
Research Article
medicine.medical_specialty
Patients
Imaging Techniques
Cerebrovascular Diseases
Science
Neuroimaging
Research and Analysis Methods
Lesion
03 medical and health sciences
Arterial occlusions
Fibrinolytic Agents
Diagnostic Medicine
Internal medicine
medicine
Humans
In patient
cardiovascular diseases
Ischemic Stroke
business.industry
Biology and Life Sciences
medicine.disease
Computed Axial Tomography
Health Care
Mild symptoms
Health Care Facilities
Reperfusion
Complication
business
030217 neurology & neurosurgery
Neuroscience
Zdroj: PLoS ONE, Vol 15, Iss 4, p e0231448 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Background and purposePatients with acute stroke and mild or rapidly improving symptoms frequently show progression. The role of reperfusion treatment in such patients is not clear. We hypothesized that progression was most likely in patients with cortical localization and such patients may benefit from thrombolysis.Material and methodsWe interrogated Hamad Stroke Database to evaluate 90-days outcome in patients with acute ischemic stroke admitted within 4 hours and a NIHSS score of ≤6. Evaluation was based on localization (lacunar or cortical), multi-model imaging abnormalities and whether they received rt-PA. The 90-day mRS was used to determine outcome.ResultsDuring study period 6381 patients were admitted with acute stroke. Mild stroke within 4 hours was diagnosed in 506 [no thrombolysis: 381(lacunar: 213; cortical: 168), thrombolysis: 125 (lacunar: 45; cortical: 80)]. The rt-PA treated patients had significantly higher NIHSS (2.94±3.9 versus 1.28±2.46, pConclusionsThe outcome in patients with mild stroke depends on lesion location (lacunar versus cortical) and severity of symptoms. Patients who receive rt-PA have significantly larger deficits, increased imaging abnormalities and higher rates of hospital complication, explaining the poor outcome in such subjects.
Databáze: OpenAIRE
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