Ana Lima Silva1, Ana Sofia Pessoa1, Renato Nogueira1, José Manuel Araújo2, José Nuno Alves2, João Pinho3, Carla Ferreira2. 1. Internal Medicine Department, Centro Hospitalar Médio Ave., Rua Cupertino de Miranda, 4761-917, V. N. de Famalicão, Portugal. 2. Neurology Department, Hospital de Braga, Sete Fontes, São Victor, 4715-243, Braga, Portugal. 3. Department of Neurology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany. jferreiradep@ukaachen.de.
Abstract
INTRODUCTION: Gaze deviation (GD) in acute ischemic stroke patients has been suggested to be associated with poor outcome and with the presence of large vessel occlusion. Our aim was to study the prognostic significance of GD in ischemic stroke patients submitted to acute revascularization treatments. METHODS: Retrospective single-center study of consecutive anterior circulation ischemic stroke patients submitted to thrombolysis and/or endovascular revascularization between 2007 and 2017. The groups of patients with and without GD were compared concerning baseline clinical and imagiological variables, functional outcome at 3 months, and survival at 1 year. RESULTS: Among a study population of 711 patients, 332 (46.7%) presented GD. Patients with GD were more frequently of female sex (p = 0.048), had higher baseline NIHSS scores (p < 0.001), had lower ASPECTS on baseline CT (p < 0.001), more frequently had ischemia of the right hemisphere (p < 0.001), presented higher NIHSS 24 hours after treatment (p < 0.001), and more frequently presented cardioembolic stroke (p = 0.003). In the unadjusted analyses, GD was associated with decreased 3-month functional independence and increased 1-month and 1 year mortality (p < 0.001). After adjustment for variables of interest, namely, for NIHSS 24 hours after treatment, GD was no longer associated with functional outcome or survival. CONCLUSIONS: GD in patients with acute ischemic stroke is associated with increased clinical and imagiological severity at baseline. However, in patients submitted to acute revascularization treatments, this does not appear to be independent predictor of functional outcome or survival.
INTRODUCTION: Gaze deviation (GD) in acute ischemic strokepatients has been suggested to be associated with poor outcome and with the presence of large vessel occlusion. Our aim was to study the prognostic significance of GD in ischemic strokepatients submitted to acute revascularization treatments. METHODS: Retrospective single-center study of consecutive anterior circulation ischemic strokepatients submitted to thrombolysis and/or endovascular revascularization between 2007 and 2017. The groups of patients with and without GD were compared concerning baseline clinical and imagiological variables, functional outcome at 3 months, and survival at 1 year. RESULTS: Among a study population of 711 patients, 332 (46.7%) presented GD. Patients with GD were more frequently of female sex (p = 0.048), had higher baseline NIHSS scores (p < 0.001), had lower ASPECTS on baseline CT (p < 0.001), more frequently had ischemia of the right hemisphere (p < 0.001), presented higher NIHSS 24 hours after treatment (p < 0.001), and more frequently presented cardioembolic stroke (p = 0.003). In the unadjusted analyses, GD was associated with decreased 3-month functional independence and increased 1-month and 1 year mortality (p < 0.001). After adjustment for variables of interest, namely, for NIHSS 24 hours after treatment, GD was no longer associated with functional outcome or survival. CONCLUSIONS: GD in patients with acute ischemic stroke is associated with increased clinical and imagiological severity at baseline. However, in patients submitted to acute revascularization treatments, this does not appear to be independent predictor of functional outcome or survival.
Authors: J P Broderick; M Lu; R Kothari; S R Levine; P D Lyden; E C Haley; T G Brott; J Grotta; B C Tilley; J R Marler; M Frankel Journal: Stroke Date: 2000-10 Impact factor: 7.914
Authors: Gian Marco De Marchis; Theresa Dankowski; Inke R König; Joachim Fladt; Felix Fluri; Henrik Gensicke; Christian Foerch; Oliver Findling; Rebekka Kurmann; Urs Fischer; Andreas Luft; Daniela Buhl; Stefan T Engelter; Philippe A Lyrer; Mirjam Christ-Crain; Marcel Arnold; Mira Katan Journal: Neurology Date: 2019-03-01 Impact factor: 9.910