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Characteristics and survival of patients with brain stem infarction
Insights
This study on ischemic brain stem infarction found a 50% seven-year survival probability. Factors like paralysis and abnormal EEG indicated a poorer prognosis for stroke patients.
Area of Science:
- Neurology
- Clinical Medicine
Background:
- Ischemic brain stem infarction is a critical neurological event.
- Prognostic factors for survival after stroke require further elucidation.
Purpose of the Study:
- To investigate long-term survival and identify prognostic indicators in patients with ischemic brain stem infarction.
Main Methods:
- Retrospective analysis of 141 patients admitted between 1966-1973.
- Follow-up via mail and death certificate procurement.
- Life table analysis for survival probability.
Main Results:
- A 50% seven-year survival probability was observed.
- Factors associated with high case fatality included soft palate paralysis, disturbed sensorium, need for intensive acute care, ECG abnormalities, elevated fasting blood glucose, and abnormal EEG.
- Preceding transient ischemic attacks (TIAs), blood pressure, cholesterol, triglycerides, and aortic arch angiogram findings did not significantly impact prognosis.
Conclusions:
- Several acute phase clinical and physiological markers significantly influence survival post-ischemic brain stem infarction.
- Prognosis is not strongly affected by factors such as prior TIAs or lipid profiles.
Abstract:
A retrospective study of 141 patients whith ischemic brain stem infarction admitted to the Department of Neurology, University of Helsinki, during 1966 to 1973 was performed. The patients were contacted by mail in January and February, 1974; in case of death, the death certificates were procured. The follow-up period was from 4 to 99 months (median 46.5 months), during which a total of 39 patients had died. A life table analysis gave a 50% probability of a seven-year survival after the stroke. Survival was similar for men and women, and age appeared to have little influence on the prognosis with only a slightly higher case fatality in old age. Soft palate paralysis, disturbed sensorium, need of special treatment measures (feeding by gastric tube intravenous infusions, etc.) during the acute phase, abnormalities in the ECG (T-wave negativity, S-T segment depression), fasting blood glucose 100 mg/100 ml or higher, and an abnormal eeg (slowing down of alpha rythm alone or in association with paroxysmal and/or focal disturbances) were all associated with high case fatality. Preceding TIAs, blood pressure level, serum cholesterol and triglyceride values, and aortic arch angiogram findings, on the other hand, had no effect upon the prognosis. The effects of body build on prognosis remained obscure.