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Related Concept Videos

Ischemic Stroke ll: Pathophysiology01:15

Ischemic Stroke ll: Pathophysiology

54
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
54
Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

44
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
44

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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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The NIHSS Score and its Components can Predict Cortical Stroke.

E Alton Sartor1, Karen Albright2, Amelia K Boehme3

  • 1Stroke Program, Department of Neurology, Tulane University Medical School, USA.

Journal of Neurological Disorders & Stroke
|February 1, 2014
PubMed
Summary
This summary is machine-generated.

A new scoring system using the National Institutes of Health Stroke Scale (NIHSS) can predict cortical damage in acute ischemic stroke (AIS) without imaging. This tool accurately identifies cortical strokes, aiding rapid treatment decisions.

Keywords:
Acute ischemic strokeCortical strokeDiffusion weighted imagingEpidemiologyMRItPA

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Area of Science:

  • Neurology
  • Emergency Medicine
  • Stroke Research

Background:

  • Neuroprotective agents for stroke are time-sensitive.
  • Rapid identification of cortical stroke is crucial for effective treatment.
  • Current methods often rely on imaging, delaying intervention.

Purpose of the Study:

  • To develop and validate a scoring system based on the NIH Stroke Scale (NIHSS) to predict cortical damage in acute ischemic stroke (AIS) without imaging.
  • To assess the accuracy of this scoring system in identifying cortical strokes.

Main Methods:

  • Retrospective analysis of patients treated with tPA for AIS at two stroke centers.
  • Classification of stroke as cortical vs. non-cortical.
  • Analysis of total NIHSS score, cortical components, and a derived cortical score for sensitivity and positive predictive value (PPV).

Main Results:

  • Diffusion-weighted MRI confirmed acute infarcts in 81% (site 1) and 70% (site 2) of patients.
  • Cortical involvement was present in 71% (site 1) and 75% (site 2).
  • A cortical score representing ≥10% of the total NIHSS score demonstrated the best combination of sensitivity and PPV for identifying cortical stroke.

Conclusions:

  • A scoring system requiring the cortical score to be at least 10% of the total NIHSS score can identify cortical strokes without imaging.
  • This approach would miss less than 10% of cortical stroke patients.
  • It would misclassify less than 18% of patients as having a cortical stroke.