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Predictors of good prognosis in total anterior circulation infarction within 6 h after onset under conventional therapy
Author(s) -
Tei H.,
Uchiyama S.,
Usui T.
Publication year - 2006
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.1600-0404.2006.00584.x
Subject(s) - medicine , modified rankin scale , stroke (engine) , logistic regression , infarction , cerebral infarction , univariate analysis , middle cerebral artery , multivariate analysis , midline shift , cardiology , surgery , ischemic stroke , ischemia , computed tomography , myocardial infarction , mechanical engineering , engineering
Objective – We investigated the predictors of good prognosis in total anterior circulation infarction (TACI), under conventional therapy. Methods – We enrolled 166 patients with first‐ever ischemic stroke within 6 h after onset with symptoms of TACI. Sixty‐three patients (38.0%) with good outcome [G group, the modified Rankin Disability Scale (mRS) after 3 months ≤3] and 103 patients (62.0%) with bad outcome (B group, mRS >3) were compared. Results – On univariate analysis, G group patients were significantly younger, had lower score in the National Institutes of Health Stroke Scale (NIHSS) of total and consciousness sub‐score, had lower rate of clinical deterioration. On cranial CT at entry, three early CT signs [hyperdense middle cerebral artery (MCA) sign, hypodensity of >1/3 MCA and brain swelling] were significantly more frequent in the B group. On the second CT at 24–48 h, infarct area as assessed by the Alberta Stroke Programme Early CT Score (ASPECTS) was significantly smaller in the G group. Multivariate analysis with logistic regression revealed age<70 years, NIHSS≤15, no clinical deterioration, and only no brain swelling in early CT signs, and ASPECTS≥7 as independent predictors of good prognosis. Conclusions – Some clinical variables are useful in predicting outcome in TACI within the early period after stroke onset.