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Posterior Circulation Stroke: Coma (More Than Time) is Brain.

Hugo Mota Dória¹, Gonçalo Videira², Daniel Ferreira³

¹Department of Neuroradiology, Centro Hospitalar Universitário do Porto, Porto, Portugal; Neuroradiology unit, Hospital Central do Funchal, Madeira, Portugal.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association

|January 30, 2022

Summary

This summary is machine-generated.

In posterior circulation stroke, coma presence is a more significant prognostic factor than time to treatment. The BATMAN score and posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) also correlate with patient outcomes.

Keywords:

BATMAN Basilar Coma Prognosis Stroke Thrombectomy pc-ASPECTS

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Area of Science:

Neurology
Vascular Neurology
Interventional Neurology

Background:

Endovascular treatment for posterior circulation stroke remains debated.
Identifying reliable prognostic factors is crucial for patient selection.
This study investigates predictors of good outcomes in posterior circulation stroke patients undergoing thrombectomy.

Purpose of the Study:

To identify key prognostic factors in posterior circulation stroke.
To evaluate the role of coma, time, and scoring systems in predicting treatment success.
To inform patient selection for endovascular therapy in posterior circulation stroke.

Main Methods:

Retrospective observational study of 126 patients with posterior circulation occlusions.
Data collected from two Portuguese hospitals between January 2015 and December 2019.
Analysis of clinical outcomes (mRS ≤2) in relation to various prognostic indicators.

Main Results:

Good clinical outcome was associated with lower incidence of coma, lower NIHSS, and higher pc-ASPECTS.
The BATMAN score also showed association with favorable outcomes.
Coma and admission pc-ASPECTS emerged as independent predictors of good outcome, independent of time metrics.

Conclusions:

Coma is a significant prognostic factor in posterior circulation stroke, potentially more so than treatment time.
The BATMAN score and pc-ASPECTS are valuable tools for assessing prognosis.
Findings support refined patient selection criteria for endovascular treatment in posterior circulation stroke.