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Outcome following occlusion of the middle cerebral artery
Author(s) -
Olsen T. S.
Publication year - 1991
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1991.tb04692.x
Subject(s) - hemiparesis , medicine , middle cerebral artery , modified rankin scale , occlusion , stroke (engine) , trunk , angiography , surgery , cardiology , ischemic stroke , ischemia , mechanical engineering , ecology , engineering , biology
Outcome was studied prospectively in 28 consecutive patients with occlusion of the middle cerebral artery (MCA). They comprise a subgroup of 101 consecutive patients with TIA or stroke ≤ 75 years of age, admitted within 72 h after the stroke. Cerebral angiography and CT‐scan were performed within 1–2 days of admission. CT‐scan was repeated 6 months later. Functional status on admission, 3 and 6 months after the stroke was evaluated using the Rankin disability scale (score 1–2: independent of others care, score 3–5: dependent on others care). The degree of hemiparesis was measured using the Medical Research Council's score. Thirteen had infarcts with a diameter >3 cm (mean 2.5 ± 0.9 cm); 15 had infarcts > 3 cm (mean 6.3 ± 1.4 cm); 10 had trunk occlusions; 18 had branch occlusions. MCA occlusions with large infarcts and severe hemiparesis on admission carried a poor outcome. Eleven (85%) of 13 patients with infarcts <3 cm were independent after 6 months; this was the case in only 1 (7%) of the 15 with infarcts > 3 cm, the remaining 14 (93%) had either died (40%) or were dependent (53%) (p < 0.00005). Eleven (85%) of 13 patients with mild hemiparesis on admission were independent, while 13 (87%) of 15 with moderate or severe hemiparesis on admission had either died (40%) or were dependent on others’care (47%) 6 months after the stroke (p < 0.0004). Type of occlusion (branch/trunk) was a poor predictor of outcome.