Analyzing post-endovascular treatment stroke prognosis with transcranial Doppler and quantitative...

Area of Science:

• Neuroscience
• Medical Imaging
• Clinical Neurology

Background:

• Successful recanalization in acute ischemic stroke does not guarantee favorable patient outcomes.
• Early identification of patients at high risk for poor prognosis is crucial for timely intervention.

Purpose of the Study:

• To determine if transcranial Doppler (TCD) and quantitative electroencephalography (qEEG) can identify patients with poor prognosis early after acute ischemic stroke.
• To develop a predictive model for early risk stratification.

Main Methods:

• Prospective study of 37 patients with successful recanalization after endovascular treatment for acute ischemic stroke.
• Assessment of 90-day prognosis using the modified Rankin Scale (mRS).
• Evaluation of brain function using TCD and qEEG, alongside clinical data and National Institutes of Health Stroke Scale (NIHSS) scores.

Main Results:

• 18 out of 37 patients had a poor prognosis (mRS >3) at 90 days.
• Independent predictors of poor prognosis included TCD pulsatility index (unaffected side), qEEG Brain Symmetry Index (BSI), and NIHSS score.
• A combined predictive model (nomogram) incorporating these factors demonstrated superior accuracy (concordance index 0.961) and good calibration.

Conclusions:

• A nomogram integrating TCD, qEEG, and NIHSS scores offers a reliable tool for individualized risk prediction.
• This model aids in guiding clinical decisions for acute ischemic stroke patients post-revascularization.