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High risk of early neurological recurrence in symptomatic carotid stenosis

Angel Ois1, Elisa Cuadrado-Godia, Ana Rodríguez-Campello

  • 1Servei de Neurologia, Hospital del Mar, IMAS, IMIM, Passeig Maritim 25-29, 08003, Barcelona, Spain. 94545@imas.imim.es

Stroke
|June 6, 2009
PubMed

Insights

Patients with mild stroke or TIA and carotid stenosis face high early neurological recurrence risk, particularly within 72 hours. This highlights the need for hyperacute stroke treatments.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Stroke Research

Background:

  • Limited data exist on very early stroke recurrence in patients with mild stroke or TIA and significant carotid stenosis.
  • Understanding hyperacute recurrence is crucial for timely intervention in these high-risk individuals.

Purpose of the Study:

  • To evaluate very early neurological recurrence (NR) and outcomes in patients with first-ever mild stroke or TIA and symptomatic carotid stenosis (>=50%).
  • To identify risk factors associated with early NR in this specific patient cohort.

Main Methods:

  • A single-center study evaluated 163 patients with symptomatic carotid stenosis and mild stroke or TIA within 6 hours of symptom onset.
  • Neurological recurrence was defined as a new neurological event or a significant increase in NIHSS score.
  • Recurrence rates were assessed at 72 hours, 7 days, and 14 days, with disability measured using the modified Rankin scale.

Main Results:

  • 27.6% of patients experienced neurological recurrence, with 20.9% occurring within the first 72 hours.
  • Carotid stenosis of 70% or higher was significantly associated with NR; diabetes showed a marginal association.
  • Disability at 2 weeks was observed in 11.7% of patients, with a strong link to NR within the first 72 hours.

Conclusions:

  • Patients with mild stroke/TIA and symptomatic carotid stenosis are at substantial risk for early neurological recurrence.
  • The findings underscore the critical need for evaluating and implementing hyperacute treatment strategies during the initial hours post-symptom onset.
Abstract

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