Journal of neurology, neurosurgery and psychiatry, 2012-06, Vol.83 (6), p.586-590
2012
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- Autor(en) / Beteiligte
- Titel
- Anterior choroidal artery ischaemic patterns predict outcome of carotid occlusion
- Ist Teil von
- Journal of neurology, neurosurgery and psychiatry, 2012-06, Vol.83 (6), p.586-590
- Ort / Verlag
- London: BMJ Publishing Group Ltd
- Erscheinungsjahr
- 2012
- Quelle
- BMJ Journals Archiv - DFG Nationallizenzen
- Beschreibungen/Notizen
- ObjectiveTo investigate whether anterior choroidal artery (AChA) territory sparing or AChA infarction restricted to the medial temporal lobe (MT), implying good collateral status, predicts good outcome, defined as modified Rankin Scale 0–2, at discharge in acute internal carotid artery (ICA) occlusion.MethodsThe authors studied consecutive patients with acute ICA occlusion admitted to an academic medical centre between January 2002 and August 2010, who underwent MRI followed by conventional angiography. The pattern of AChA involvement on initial diffusion-weighted imaging was dichotomised as spared or MT only versus other partial or full. The association of AChA infarct patterns and good outcome at discharge was calculated by multivariate logistic regression with adjustment.ResultsFor the 60 patients meeting entry criteria, mean age was 68.3 years and median admission NIH Stroke Scale score was 19. AChA territory was spared or restricted to the MT in 27 patients and other partially involved or fully involved in 33 patients. AChA territory spared or ischaemia restricted to MT only, compared with other partial infarct patterns or full infarct, was independently associated with good discharge outcome (44.4% vs 12.1%, OR 7.24, 95% CI 1.32 to 39.89, p=0.023).ConclusionIn acute ICA occlusion, the absence of AChA infarction or restriction to the MT is an independent predictor of good discharge outcome. Analysis of AChA infarct patterns may improve early prognostication and decision-making.
- Sprache
- Englisch
- Identifikatoren
- ISSN: 0022-3050eISSN: 1468-330XDOI: 10.1136/jnnp-2011-301493Titel-ID: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4157912
- Format
- –
- Schlagworte
- acute ischaemic stroke, Age, Aged, Aged, 80 and over, Angiography, anterior choroidal artery, Biological and medical sciences, Brain Ischemia - complications, Brain Ischemia - pathology, Cardiovascular disease, Carotid artery, Carotid Stenosis - complications, Carotid Stenosis - diagnosis, Carotid Stenosis - pathology, Cerebral blood flow, Cerebral infarction, Cerebral Infarction - complications, Cerebral Infarction - diagnosis, Cerebral Infarction - pathology, cerebrovascular disease, collateral, collateral circulation, collaterals, Decision making, Diffusion Magnetic Resonance Imaging - methods, diffusion weighted imaging, Female, Heart attacks, Humans, Infarction - complications, Infarction - diagnosis, Infarction - pathology, Internal carotid artery occlusion, Intervention, Ischemia, Magnetic resonance imaging, Magnetic Resonance Imaging - methods, Male, Medical imaging, Medical sciences, Middle Aged, mismatch, modified Rankin Scale, moyamoya, MRI, Neuroimaging - methods, Neurology, Neurosurgery, neurourology, Occlusion, speech therapy, Statistical analysis, Stroke, swallowing, Temporal lobe, Temporal Lobe - pathology, Territory, Vascular diseases and vascular malformations of the nervous system, Veins & arteries