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Ultrasonographic prediction of patients' outcome in hyperacute ischemic stroke
Masatoshi Koga1, Kazumi Kimura, Kazuo Minematsu
1Cerebrovascular Division, Department of Medicine, National Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan. mkoga@intmed2.med.kyushu-u.acjp
Objective:
We examined whether carotid ultrasonographic (US) findings in hyperacute ischemic stroke are useful to predict patients' outcome.
Methods:
We studied 73 consecutive patients with carotid stroke using both computed tomography (CT) and duplex carotid ultrasonography within 6 h of stroke onset. We evaluated early CT findings defined as obscuration of the lentiform nucleus, loss of the insular ribbon and/or cortical effacement, and US findings indicating internal carotid artery (ICA) or middle cerebral artery trunk occlusion. The National Institute of Health Stroke Scale (NIHSS) at admission and modified Rankin scale on day 30 were assessed.
Results:
According to multiple logistic regression analysis, positive US findings (P = 0.0045, odds ratio, 11.1) provided the best predictor of modified Rankin scale score > or =3 compared with a baseline NIHSS> or =16 (P = 0.036, odds ratio, 7.9) and early CT findings (P = 0.18).
Conclusion:
US findings of hyperacute stroke may provide a better predictor of patients' outcome.