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P38 Objective: To examine clinical outcome of patients  presenting with acute stroke who have normal cerebral angiography.Methods: From November 1994 to June 2000, patients with  stroke onset of less than 6 hours underwent cerebral angiography prior  to intra-arterial thrombolysis. Seventeen patients (15 male, 2 female;  mean age 64, range 42–89) with a discharge diagnosis of stroke had  normal cerebral angiography. Admission NIH stroke scale (NIHSS) and  Rankin score at discharge were obtained in all patients, as well as  follow-up CT and/or MR greater than 24 hours after symptom onset. Good  outcome was defined as a Rankin score of 0,1, or 2. Poor outcome was  defined as a Rankin score of 3 or greater. Patients were divided into 2  categories based on CT/MR findings: lacunar infarct (single or  multiple) and cortical infarct. Discharge Rankin scores were correlated  with admission NIHSS and findings on follow-up CT/MR.Results: All patients had a discharge Rankin score of 4 or  less. Eleven (65%) patients had a poor outcome at discharge and 6  (35%) had a good outcome at discharge. No patient had a normal  follow-up CT/MR. All patients with a poor outcome at discharge had a  new infarct on follow-up CT/MR. Seven had a new lacunar infarct and 4  had a new cortical infarct. Five (83%) of the 6 patients with good  outcome at discharge had new infarcts, 3 lacunar, and 2 cortical. The  sixth patient in this group had no new infarct. Admission NIHSS did not  correlate with a poor outcome at discharge (Rankin &gt;2; p&gt;0.05,  Mann-Whitney).Conclusion: Our results indicate that the  majority of patients presenting with acute stroke who have a normal  angiogram will have a poor clinical outcome at discharge. Niether  admission NIHSS nor follow-up CT/MR were found to reliably predict  patient outcome at discharge.

Correlation of Clinical Outcome and CT/MR in Acute Stroke Patients with Normal Cerebral Angiography