Paola Caruso1, Mariana Ridolfi2, Carlo Lugnan2, Milos Ajčević2,3, Giovanni Furlanis2, Giulia Bellavita2, Roberta Antea Pozzi Mucelli4, Adrian Zdjelar4, Maja Ukmar4, Marcello Naccarato2, Alex Buoite Stella2, Paolo Manganotti2. 1. Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy. caruso.paola1983@libero.it. 2. Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy. 3. Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio, 10, 34127, Trieste, Italy. 4. Radiology Unit, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy.
Abstract
BACKGROUND AND PURPOSE: Diagnosis of posterior circulation stroke may be challenged. National Institutes of Health Stroke Scale (NIHSS) and brain imaging (non-contrast brain computed tomography-CT) are used for diagnosis; evaluation on posterior circulation stroke remains a limit of NIHSS, and the value of non-contrast CT (NCCT) is limited due to artifacts caused by the bones of the base of the skull. We tested the validity and prognostic value of posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) in patients with posterior circulation stroke. METHODS: Pc-ASPECTS allots the posterior circulation 10 points. We studied 50 patients with posterior circulation stroke. We applied pc-ASPECTS to NCCT, CT angiography, and CT Perfusion. We evaluated the correlation of pc-ASPECT with outcome parameters for stroke. RESULTS: Out of 50 patients, CTP showed abnormalities in 34 cases. The pc-ASPECT score calculated on brain CT and on the brain CT + angio CT had a sensibility of 24%, calculated on brain CT, angio CT and CTPerfusion gain a sensibility of 72%. Pc-ASPECT MTT resulted to be the more reliable parameter: outcome given by NIHSS score at discharge, mRS at discharge, and at 3 months was more severe in patients with Pc-ASPECT MTT alteration. Outcome given by NIHSS score at discharge and mRS at discharge and 1 at 3 months was more severe in patients with higher NIHSS score at admission. CONCLUSION: We evaluated the usefulness of pc-ASPECTS on CTP in predicting functional outcome in acute posterior circulation stroke that appears to be a powerful marker for predicting functional outcome.
BACKGROUND AND PURPOSE: Diagnosis of posterior circulation stroke may be challenged. National Institutes of Health Stroke Scale (NIHSS) and brain imaging (non-contrast brain computed tomography-CT) are used for diagnosis; evaluation on posterior circulation stroke remains a limit of NIHSS, and the value of non-contrast CT (NCCT) is limited due to artifacts caused by the bones of the base of the skull. We tested the validity and prognostic value of posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) in patients with posterior circulation stroke. METHODS: Pc-ASPECTS allots the posterior circulation 10 points. We studied 50 patients with posterior circulation stroke. We applied pc-ASPECTS to NCCT, CT angiography, and CT Perfusion. We evaluated the correlation of pc-ASPECT with outcome parameters for stroke. RESULTS: Out of 50 patients, CTP showed abnormalities in 34 cases. The pc-ASPECT score calculated on brain CT and on the brain CT + angio CT had a sensibility of 24%, calculated on brain CT, angio CT and CTPerfusion gain a sensibility of 72%. Pc-ASPECT MTT resulted to be the more reliable parameter: outcome given by NIHSS score at discharge, mRS at discharge, and at 3 months was more severe in patients with Pc-ASPECT MTT alteration. Outcome given by NIHSS score at discharge and mRS at discharge and 1 at 3 months was more severe in patients with higher NIHSS score at admission. CONCLUSION: We evaluated the usefulness of pc-ASPECTS on CTP in predicting functional outcome in acute posterior circulation stroke that appears to be a powerful marker for predicting functional outcome.
Authors: Fana Alemseged; Darshan G Shah; Andrew Bivard; Timothy J Kleinig; Nawaf Yassi; Marina Diomedi; Francesca Di Giuliano; Gagan Sharma; Roy Drew; Bernard Yan; Richard J Dowling; Steven Bush; Fabrizio Sallustio; Carlo Caltagirone; Nicola B Mercuri; Roberto Floris; Mark W Parsons; Christopher R Levi; Peter J Mitchell; Stephen M Davis; Bruce Cv Campbell Journal: Int J Stroke Date: 2017-11-21 Impact factor: 5.266
Authors: L-P Pallesen; D Lambrou; A Eskandari; J Barlinn; K Barlinn; H Reichmann; V Dunet; P Maeder; V Puetz; P Michel Journal: Eur J Neurol Date: 2018-03-13 Impact factor: 6.089
Authors: Helen M Dewey; Jonathan Sturm; Geoffrey A Donnan; Richard A L Macdonell; John J McNeil; Amanda G Thrift Journal: Cerebrovasc Dis Date: 2003 Impact factor: 2.762
Authors: Volker Puetz; P N Sylaja; Shelagh B Coutts; Michael D Hill; Imanuel Dzialowski; Pia Mueller; Ulf Becker; Gabriele Urban; Christine O'Reilly; Philip A Barber; Pranshu Sharma; Mayank Goyal; Georg Gahn; Ruediger von Kummer; Andrew M Demchuk Journal: Stroke Date: 2008-07-10 Impact factor: 7.914