BACKGROUND: Stroke in aged patients has a relatively poor prognosis, even after recanalizing therapy. Potential reasons include mechanisms that relate directly to the extent of brain tissue damage, but also age-dependent factors which are not, or only indirectly, stroke-related, such as pre-existing functional deficits, comorbidities, and post-stroke complications (eg, infections). OBJECTIVE: To compare early neurological course with subsequent functional outcome in older (≥80 years) and younger stroke patients in order to estimate the relative impact of these factors. Specifically, to examine if the strong age-dependency of modified Rankin Scale (mRS) outcome scores in stroke patients after mechanical thrombectomy is paralleled by a similar age dependency of early postinterventional National Institute of Health Stroke Scale (NIHSS) scores-a more specific measure of stroke-induced brain damage. METHODS: We evaluated technical results, pre- and postinterventional NIHSS scores, mid-term mRS scores and early and overall mortality and their relation to age in 125 patients, 40 of them ≥80 years, with acute middle cerebral artery occlusion, treated by mechanical thrombectomy. RESULTS: Technical success, pre- and postinterventional NIHSS scores and early mortality were age-independent. Early neurological improvement depended on successful recanalization, but not on age. Nevertheless, good mRS outcome (mRS 0-2) was much rarer, and overall mortality almost threefold higher in aged patients. CONCLUSIONS: Older patients exhibit a similar early neurological course and responsiveness to mechanical thrombectomy as younger patients, but this is not reflected in mid-term functional outcome scores. This indicates that post-stroke complications and other factors that are not, or only indirectly, related to the brain tissue damage induced by the incident stroke have a dominant role in their poor prognosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND:Stroke in aged patients has a relatively poor prognosis, even after recanalizing therapy. Potential reasons include mechanisms that relate directly to the extent of brain tissue damage, but also age-dependent factors which are not, or only indirectly, stroke-related, such as pre-existing functional deficits, comorbidities, and post-stroke complications (eg, infections). OBJECTIVE: To compare early neurological course with subsequent functional outcome in older (≥80 years) and younger strokepatients in order to estimate the relative impact of these factors. Specifically, to examine if the strong age-dependency of modified Rankin Scale (mRS) outcome scores in strokepatients after mechanical thrombectomy is paralleled by a similar age dependency of early postinterventional National Institute of Health Stroke Scale (NIHSS) scores-a more specific measure of stroke-induced brain damage. METHODS: We evaluated technical results, pre- and postinterventional NIHSS scores, mid-term mRS scores and early and overall mortality and their relation to age in 125 patients, 40 of them ≥80 years, with acute middle cerebral artery occlusion, treated by mechanical thrombectomy. RESULTS: Technical success, pre- and postinterventional NIHSS scores and early mortality were age-independent. Early neurological improvement depended on successful recanalization, but not on age. Nevertheless, good mRS outcome (mRS 0-2) was much rarer, and overall mortality almost threefold higher in aged patients. CONCLUSIONS: Older patients exhibit a similar early neurological course and responsiveness to mechanical thrombectomy as younger patients, but this is not reflected in mid-term functional outcome scores. This indicates that post-stroke complications and other factors that are not, or only indirectly, related to the brain tissue damage induced by the incident stroke have a dominant role in their poor prognosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Ralph Weber; Gernot Reimann; Christian Weimar; Angela Winkler; Klaus Berger; Hannes Nordmeyer; Jeffrie Hadisurya; Friedhelm Brassel; Martin Kitzrow; Christos Krogias; Werner Weber; Elmar W Busch; Jens Eyding Journal: Ther Adv Neurol Disord Date: 2015-11-26 Impact factor: 6.570
Authors: Johannes Kaesmacher; Christian Maegerlein; Mirjam Kaesmacher; Claus Zimmer; Holger Poppert; Benjamin Friedrich; Tobias Boeckh-Behrens; Justus F Kleine Journal: J Am Heart Assoc Date: 2017-02-15 Impact factor: 5.501
Authors: Christoph C Kurmann; Adnan Mujanovic; Eike I Piechowiak; Tomas Dobrocky; Felix Zibold; Morin Beyeler; Jan Vynckier; David Seiffge; Thomas R Meinel; Pasquale Mordasini; Marcel Arnold; Urs Fischer; Jan Gralla; Johannes Kaesmacher Journal: Clin Neuroradiol Date: 2022-01-06 Impact factor: 3.156