BACKGROUND: The aim of this study was to determine the clinical and radiological outcome of acute stroke patients who had no vessel occlusion on arteriography and to define predictors of clinical outcome. METHODS: We analyzed clinical and radiological data of stroke patients whose arteriography performed within 6 hours of symptom onset did not visualize any vessel occlusion. RESULTS: Twenty-eight of 283 consecutive patients (10%) who underwent arteriography with the intention to perform intraarterial thrombolysis did not show any arterial occlusion. Their median baseline National Institutes of Health Stroke Scale (NIHSS) score was 7. Time from symptom onset to arteriography ranged from 115 to 315 minutes; on average, it was 226 minutes. Presumed stroke cause was cardiac embolism in 11 patients (39%), small artery disease in 6 (21%), coronary angiography in 1 (4%), and undetermined in 10 patients (36%). After 3 months, modified Rankin Scale score (mRS) was < or =2 in 21 patients (75%), indicating a favorable outcome. Six patients (21%) had a poor outcome (mRS 3 or 4) and 1 patient (4%) had a myocardial infarction and died. Twenty-seven patients had follow-up brain imaging. It was normal in 5, showed a lacunar lesion in 8, a striatocapsular infarct in 2, a small or medium-sized anterior circulation infarct in 6, multiple small anterior circulation infarcts in 2, and multiple posterior circulation infarcts in 4. No predictors of clinical outcome were identified. CONCLUSIONS: Most acute stroke patients with normal early arteriography show infarcts on brain imaging; however, clinical outcome is usually favorable.
BACKGROUND: The aim of this study was to determine the clinical and radiological outcome of acute strokepatients who had no vessel occlusion on arteriography and to define predictors of clinical outcome. METHODS: We analyzed clinical and radiological data of strokepatients whose arteriography performed within 6 hours of symptom onset did not visualize any vessel occlusion. RESULTS: Twenty-eight of 283 consecutive patients (10%) who underwent arteriography with the intention to perform intraarterial thrombolysis did not show any arterial occlusion. Their median baseline National Institutes of Health Stroke Scale (NIHSS) score was 7. Time from symptom onset to arteriography ranged from 115 to 315 minutes; on average, it was 226 minutes. Presumed stroke cause was cardiac embolism in 11 patients (39%), small artery disease in 6 (21%), coronary angiography in 1 (4%), and undetermined in 10 patients (36%). After 3 months, modified Rankin Scale score (mRS) was < or =2 in 21 patients (75%), indicating a favorable outcome. Six patients (21%) had a poor outcome (mRS 3 or 4) and 1 patient (4%) had a myocardial infarction and died. Twenty-seven patients had follow-up brain imaging. It was normal in 5, showed a lacunar lesion in 8, a striatocapsular infarct in 2, a small or medium-sized anterior circulation infarct in 6, multiple small anterior circulation infarcts in 2, and multiple posterior circulation infarcts in 4. No predictors of clinical outcome were identified. CONCLUSIONS: Most acute strokepatients with normal early arteriography show infarcts on brain imaging; however, clinical outcome is usually favorable.
Authors: Wolfgang G Kunz; Wieland H Sommer; Lukas Havla; Franziska Dorn; Felix G Meinel; Olaf Dietrich; Grete Buchholz; Birgit Ertl-Wagner; Kolja M Thierfelder Journal: Eur Radiol Date: 2016-10-08 Impact factor: 5.315
Authors: Wade S Smith; Michael H Lev; Joey D English; Erica C Camargo; Maggie Chou; S Claiborne Johnston; Gilberto Gonzalez; Pamela W Schaefer; William P Dillon; Walter J Koroshetz; Karen L Furie Journal: Stroke Date: 2009-10-15 Impact factor: 7.914
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Authors: Alex Förster; Hans Ulrich Kerl; Holger Wenz; Marc A Brockmann; Ingo Nölte; Christoph Groden Journal: PLoS One Date: 2013-10-10 Impact factor: 3.240
Authors: Antonio Siniscalchi; Piergiorgio Lochner; Paolo Perrotta; Stefano Rizzuto; Giovambattista De Sarro; Luca Gallelli Journal: West J Emerg Med Date: 2018-04-05