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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Neurological deterioration in patients with first-ever ischemic stroke
1Department of Neurology, Chia-Yi Christian Hospital, Chia-Yi, Taiwan. ctong98@yahoo.com.tw
Acta Neurologica Taiwanica
|October 31, 2007
Summary
Early neurological deterioration (ND) affects over 30% of ischemic stroke patients, often within 48 hours. Elevated C-reactive protein and anterior circulation infarction are key risk factors, necessitating prompt treatment.
Area of Science:
- Neurology
- Clinical Medicine
- Stroke Research
Background:
- Early neurological deterioration (ND) is a significant concern in ischemic stroke patients.
- Understanding the frequency and risk factors of ND is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the frequency and identify risk factors for early neurological deterioration in patients with first-ever ischemic stroke.
- To analyze the time course and impact of ND on functional outcomes and mortality.
Main Methods:
- A prospective study involving 121 patients with first-ever ischemic stroke.
- Initial evaluation within 24 hours of stroke onset, followed by 2-month monitoring.
- Assessment using the National Institutes of Health Stroke Scale (NIHSS) and Barthel Index (BI).
Main Results:
- 31.4% of patients experienced early ND, with 65.8% of these cases occurring within 48 hours of initial evaluation.
- ND onset was typically between day 1 and day 3 post-stroke, with improvement following the nadir.
- Elevated C-reactive protein levels and total anterior circulation infarction were identified as significant risk factors for ND.
Conclusions:
- Early neurological deterioration is common in ischemic stroke and is associated with increased mortality and poorer functional outcomes.
- Prompt identification of risk factors like elevated C-reactive protein and specific infarction types is vital.
- Aggressive and early treatment strategies are recommended to mitigate stroke progression and improve patient prognosis.
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