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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

Progression in acute ischemic stroke: frequency, risk factors and prognosis

Murat Sumer1, Iklim Ozdemir, Ozcan Erturk

  • 1Neurology Department, Zonguldak Karaelmas University Medical Faculty, Neurology Department, 67700 Kozlu Zonguldak, Turkey. mmsumer@ixir.com

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|March 15, 2003
PubMed

Insights

Neurological worsening in acute ischemic stroke patients is linked to posterior circulation involvement and noncardioembolic infarction. This deterioration significantly impacts long-term prognosis and survival rates.

Area of Science:

  • Neurology
  • Stroke Medicine
  • Clinical Neuroscience

Background:

  • Ischemic stroke is a leading cause of death and disability worldwide.
  • Understanding factors influencing stroke progression is crucial for patient management.
  • Clinical deterioration in acute ischemic stroke patients can significantly alter outcomes.

Purpose of the Study:

  • To determine the frequency of neurological deterioration in acute ischemic stroke.
  • To identify predictive factors associated with stroke worsening.
  • To evaluate the impact of deterioration on prognosis and functional outcomes.

Main Methods:

  • A cohort of 266 acute ischemic stroke patients presenting within 24 hours of onset was studied.
  • Clinical deterioration was defined as a decrease of ≥1 point on the Canadian Neurological Scale (CNS).
  • Patient outcomes were assessed using the Rankin Score (RS) at discharge and six months post-stroke.

Main Results:

  • Approximately 9.8% of patients (26 out of 266) experienced clinical deterioration.
  • Independent predictors of neurological worsening included posterior circulation involvement (OR 3.16) and noncardioembolic infarction (OR 4.5).
  • Mortality rates were higher in the progressive group (19.2%) compared to the non-progressive group (4.16%), with worse functional outcomes at discharge and six months.

Conclusions:

  • Posterior circulation involvement and noncardioembolic infarcts are significant independent predictors of neurological progression in acute ischemic stroke.
  • Clinical deterioration in acute ischemic stroke is associated with a substantially worse prognosis.
  • Early identification of these risk factors may allow for targeted interventions to improve stroke outcomes.
Abstract

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