Predicting spontaneous early neurological recovery after acute ischemic stroke

Abstract

Objective: We evaluated the 30-day outcomes of early (≤ 14 days) or delayed (15 days to three months) carotid revascularization (CR) performed in patients who presented acute brain infarction secondary to internal carotid artery (ICA) stenosis. Methods: We included all patients with a recent cerebral infarction from July 2010 to June 2014 who underwent CR in our center within three months after the onset of symptoms for ICA stenosis. Data were retrospectively collected. Two groups were identifi ed: Group A included patients who underwent early CR within the fi rst fourteen days after symptom onset, and Group B, patients who underwent delayed CR, from the fi fteenth day up to the third month after symptom onset. Death, stroke and major adverse cardiac events (MACE) were analyzed. Results: Seventy-one patients underwent CR (73.2% men, with a median age of 71). Nineteen patients underwent early CR and 52 underwent delayed CR. The mean interval from initial examination to surgery was 9.5 days (range, 3-14 days) in Group A and 42 days (range, 15-92 days) in Group B. No complication occurred in Group A within the 30 postoperative days. In Group B, no MACE or death was observed and two patients presented with post-operative stroke (3.8%). Conclusion: This retrospective study confi rmed the satisfactory outcomes of early CR after acute brain infarct. Accurate clinical and radiological selection of patients prevents early neurological complications.

Clinical Implications of Headache in Lacunar Stroke: Relevance of Site of Infarct

“…In agreement with the favorable prognosis of dysarthria‐clumsy hand, 9,30 this subtype of lacunar syndrome also appeared as an independent predictor of early neurological recovery in the logistic regression analysis.…”

Timing of Neurological Improvement after Acute Ischemic Stroke and Functional Outcome

“…In our regression analysis, these variables were also identified as independent predictors, corroborating the results of previous studies. With regard to stroke subtype, lacunar stroke or dysarhria-clumsy hand syndrome has been suggested as a significant predictor of spontaneous good outcome [5,20]. In our study, lacunar infarction was associated with a good outcome, but after multivariate adjustment, the association was not significant.…”

Stroke severity and early recovery after first-ever ischemic stroke: Results of a hospital-based study in Taiwan

“…at 7 or 30 days following hospital admission) or in a clinical trial setting [1][2][3][4]. Furthermore, in studying acute hospitalization recovery in patients with ischemic stroke, previous studies focused solely on single outcome measure such as the modified Rankin scale [16] or the Barthel Index [14].…”