OBJECTIVES: Cerebral autoregulation is particularly challenged in acute ischemic stroke. We investigated (1) clinical and radiological factors related to dynamic cerebral autoregulation (DCA) in acute stroke and (2) the relationship between DCA and clinical outcome of stroke. METHODS: A total of 45 patients with middle cerebral artery (MCA) stroke were analyzed pooling two previous studies. DCA was measured by transcranial Doppler in both MCAs early (within 48 h from onset) and late (day 5-7) using low-frequency phase and correlation analysis (index Mx). Outcome was assessed by modified Rankin scale after a mean period of 4 months. RESULTS: Mx increased (i.e. autoregulation worsened) between the early and late measurement, more so on affected (P = 0.005) than on unaffected sides (P = 0.014). Poorer autoregulation as indicated by lower ipsilateral phase (early and late) and higher Mx (late measurement) were significantly related to larger infarction. More severe stroke was significantly related to poorer ipsilateral Mx and phase. Ipsilateral phase in the early (P = 0.019) and Mx in the late measurement (P =0..016) were related to poor clinical outcome according to univariate analysis. CONCLUSIONS: Impairment of DCA ipsilateral to acute ischemic stroke is associated with larger infarction. Dysautoregulation tends to worsen and spread to the contralateral side over the first days post-stroke and is associated with poor clinical outcome.
OBJECTIVES: Cerebral autoregulation is particularly challenged in acute ischemic stroke. We investigated (1) clinical and radiological factors related to dynamic cerebral autoregulation (DCA) in acute stroke and (2) the relationship between DCA and clinical outcome of stroke. METHODS: A total of 45 patients with middle cerebral artery (MCA) stroke were analyzed pooling two previous studies. DCA was measured by transcranial Doppler in both MCAs early (within 48 h from onset) and late (day 5-7) using low-frequency phase and correlation analysis (index Mx). Outcome was assessed by modified Rankin scale after a mean period of 4 months. RESULTS: Mx increased (i.e. autoregulation worsened) between the early and late measurement, more so on affected (P = 0.005) than on unaffected sides (P = 0.014). Poorer autoregulation as indicated by lower ipsilateral phase (early and late) and higher Mx (late measurement) were significantly related to larger infarction. More severe stroke was significantly related to poorer ipsilateral Mx and phase. Ipsilateral phase in the early (P = 0.019) and Mx in the late measurement (P =0..016) were related to poor clinical outcome according to univariate analysis. CONCLUSIONS: Impairment of DCA ipsilateral to acute ischemic stroke is associated with larger infarction. Dysautoregulation tends to worsen and spread to the contralateral side over the first days post-stroke and is associated with poor clinical outcome.
Authors: Dean Montgomery; Charles Brown; Charles W Hogue; Ken Brady; Mitsunori Nakano; Yohei Nomura; Andre Antunes; Paul S Addison Journal: Anesth Analg Date: 2019-12-27 Impact factor: 5.108
Authors: Eva A Mistry; Tapan Mehta; Akshitkumar Mistry; Niraj Arora; Amy K Starosciak; Felipe De Los Rios La Rosa; James Ernest Siegler; Rohan Chitale; Mohammad Anadani; Shadi Yaghi; Pooja Khatri; Adam de Havenon Journal: Stroke Date: 2019-12-09 Impact factor: 7.914
Authors: Ashwin B Parthasarathy; Kimberly P Gannon; Wesley B Baker; Christopher G Favilla; Ramani Balu; Scott E Kasner; Arjun G Yodh; John A Detre; Michael T Mullen Journal: J Cereb Blood Flow Metab Date: 2017-12-12 Impact factor: 6.200
Authors: Santiago Ortega-Gutierrez; Edgar A Samaniego; Amy Huang; Arjun Masurkar; Binbin Zheng-Lin; Colin P Derdeyn; David Hasan; Randolph Marshall; Nils Petersen Journal: J Vasc Interv Neurol Date: 2018-06