Defining minor symptoms in acute ischemic stroke

Cerebrovascular Diseases
Davide StramboMaria Sessa

Abstract

Thrombolysis is often withheld from acute ischemic stroke patients presenting with mild symptoms; however, up to 40% of these patients end up with a poor outcome when left untreated. Since there is lack of consensus on the definition of minor symptoms, we aimed at addressing this issue by looking for features that would better predict functional outcomes at 3 months. Among all acute ischemic stroke patients admitted to our Stroke Unit (n = 1,229), we selected a cohort of patients who arrived within 24 hours from symptoms onset, with baseline NIHSS ≤6, not treated with thrombolysis (n = 304). Epidemiological data, comorbidities, radiological features and clinical presentation (NIHSS items) were collected to identify predictors of outcome. Our cohort was tested against minor stroke definitions selected from the literature and a newly proposed one. Three months after stroke onset, 97 patients (31.9%) had mRS ≥ 2. Independent predictors of poor outcome were age (OR 0.97 [95% CI 0.95-9.99]) and baseline NIHSS score (OR 0.79 [95% CI 0.67-0.94]), while cardioembolic aetiology was negatively associated (OR 3.29 [95% CI 1.51-7.14]). Items of NIHSS associated with poor outcome were impairment of right motor arm (OR 0.49 [95% CI 0.27-0.91...Continue Reading

Citations

Mar 3, 2017·Cerebrovascular Diseases Extra·Kenji MaruyamaKazuo Kitagawa
Mar 21, 2017·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Jay Chol ChoiUNKNOWN CRCS-5 Investigators
Jul 2, 2016·The Neurohospitalist·Shadi YaghiBernadette Boden-Albala
Feb 13, 2019·PM & R : the Journal of Injury, Function, and Rehabilitation·Jaclyn K SchwartzStephen J Page
Jan 23, 2020·Translational Stroke Research·Xiao WangBo Song
Oct 22, 2020·Stroke; a Journal of Cerebral Circulation·Hamidreza SaberJeffrey L Saver

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