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Updated: Feb 24, 2026

A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
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Time to Neurological Deterioration in Ischemic Stroke.

James E Siegler1, Karen C Albright2,3,4,5, Alexander J George1

  • 1Stroke Program, Department of Neurology, Tulane University Hospital, New Orleans, LA 70112.

Medical Student Research Journal
|August 15, 2017
PubMed
Summary

Neurological deterioration (ND) after stroke is common. Non-reversible causes of ND occur significantly sooner than reversible causes, impacting stroke patient outcomes.

Keywords:
Acute ischemic strokelatencyneurological deteriorationtime to event analysis

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Area of Science:

  • Neurology
  • Stroke Medicine
  • Clinical Outcomes

Background:

  • Neurological deterioration (ND) is a frequent complication following ischemic stroke, often occurring within 24-48 hours.
  • The relationship between the timing of ND and its underlying causes (etiology) and reversibility remains underexplored.

Purpose of the Study:

  • To investigate the timing of neurological deterioration (ND) in ischemic stroke patients.
  • To analyze the association between ND timing and the reversibility of its etiologies.

Main Methods:

  • Defined ND as a ≥2-point increase in NIH Stroke Scale (NIHSS) within 24 hours.
  • Categorized ND etiologies as reversible or non-reversible based on potential impact on cerebral perfusion.
  • Utilized log-normal survival modeling to analyze time to ND.

Main Results:

  • 54.9% of ND events occurred within 48 hours of last known well.
  • Median time to ND was shorter for non-reversible causes (1.5 days) vs. reversible causes (2.6 days) (p=0.011).
  • Increased age and admission NIHSS score were associated with a shorter time to ND.

Conclusions:

  • Patients with non-reversible ND causes experienced significantly faster deterioration compared to those with reversible causes.
  • Age and stroke severity (NIHSS) are critical factors influencing the timing of neurological deterioration.