Very prolonged capsular warning syndrome

Makita, Naoki; Yamamoto, Yasumasa; Nagakane, Yoshinari; Ashida, Shinji; Mizuno, Toshiki

doi:10.1016/j.jns.2015.03.023

“…Regardless of the various available treatments being used, it remains unclear whether these treatments alter the natural course of the syndrome. Intravenous thrombolysis, double antiplatelet therapy, single antiplatelet therapy, anticoagulants, and vasopressors have been used to treat patients with CWS [1, 4, 5, 7, 9–13, 23–29]. However, it remains uncertain whether any of these therapies can change the progression of the syndrome.…”

Section: Discussionmentioning

confidence: 99%

Capsular warning syndrome: clinical analysis and treatment

He

¹

,

Xu

²

,

Wang

³

et al. 2019

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BackgroundCapsular warning syndrome (CWS) is a rare clinical syndrome, which is defined as a recurrent transient lacunar syndrome. The mechanism and clinical management of CWS remain unclear. The aim of the study was to discuss the clinical characteristics of CWS and evaluate the different outcome between rt-PA and no rt-PA therapy.MethodsThe present multicenter retrospective study involved three medical centers, and the clinical data were collected from patients with CWS between January 2013 and December 2018. The clinical characteristics of CWS were analyzed. Patients were divided into two groups: rt-PA and no rt-PA groups. The therapeutic effects and prognosis of these two groups were analyzed. A good prognosis was defined as 3-month modified Rankin Scale (mRS) ≤ 2.ResultsOur study included 72 patients, 27 patients were assigned to rt-PA group, 45 in no rt-PA group. Hypertension and dyslipidemia were the most common risk factors. The mean number of episodes before irreversible neurological impairment or the symptoms completely disappeared was five times (range: 3–11 times). A total of 58 (80.55%) patients had acute infarction lesions on the diffusion weighted imaging (DWI). The most common infarct location was the internal capsule (41,70.69%), followed by the thalamus and pons. The difference in therapeutic effects between the rt-PA, single and double antiplatelet groups was not statistically significant (P > 0.05). A good prognosis was observed in 61 (84.72%) patients after 3 months, in which 23 (23/27, 85.19%) patients were from the rt-PA group and 38 (38/45,84.44%) patients were from the no rt-PA group (P > 0.05). After 3 months of follow-up, two patients had recurrent ischemic stroke.ConclusionThe most effective treatment of CWS remains unclear. Intravenous thrombolysis is safe for CWS patients. Regardless of the high frequency of infarction in CWS patients, more than 80% patients had a favorable functional prognosis.

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“…Despite various treatments being available and used, it was unclear whether these treatments alter the natural course of the syndrome. Intravenous thrombolysis, double antiplatelet therapy, single antiplatelet therapy,anticoagulants, vasopressors had been used to treat patients with CWS [1,4,5,7,[9][10][11][12][13][18][19][20][21][22][23][24][25][26], it remains uncertain whether any of these therapies were able to change the progression of the syndrome. There was no strong evidence for the efficacy of anticoagulant therapy in the acute phase of CWS.…”

Section: Discussionmentioning

confidence: 99%

Capsular Warning Syndrome: Clinical Analysis and Treatment

He

¹

,

Xu²,

Wang

³

et al. 2019

Preprint

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Background: Capsular warning syndrome (CWS) was a rare clinical syndrome, which was defined as recurrent transient lacunar syndromes. The mechanism and clinical management of CWS were not clear. The purpose of this study was to discuss the clinical characteristics, treatment and prognosis of the CWS. Methods: This was a multicenter retrospective study that involved three medical centers, we collected clinical data from patients with CWS between January 2013 and December 2018. We analyzed the clinical characteristics of the CWS. Patients with CWS were divided into two groups: rt-PA and no rt-PA groups. We analyzed the therapeutic effects and prognosis between different groups. Results: This study included 72 patients, 27 in rt-PA group, 45 in no rt-PA group, hypertension and dyslipidemia were the most common risk factors. The mean number of episodes before an irreversible neurological impairment or the symptoms completely disappeared was 5 times(3-11). 59 (81.94%) patients had acute infarction lesions on the diffusion weighted imaging (DWI). The most common infarct location was the internal capsule (76.38%,55), followed by the thalamus and pons. The difference in therapeutic effects between rt-PA, single and double antiplatelet groups was not significant(P>0.05). A good prognosis was observed in 61 (84.72%) patients at 3-month, 23 (23/27, 85.19%) patients in rt-PA group and 38 (38/45,84.44%) patients in no rt-PA group(P>0.05). After 3 months of follow-up, 2 patients had recurrent ischemic stroke. Conclusions: The most effective treatment of CWS remains unclear. Despite the high incidence of infarction in CWS patients, more than 80% patients had favorable functional prognosis

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“…Despite various treatments being available and used, it was unclear whether these treatments alter the natural course of the syndrome. Intravenous thrombolysis, double antiplatelet therapy, single antiplatelet therapy, anticoagulants, vasopressors had been used to treat patients with CWS [1,4,5,7,[9][10][11][12][13][20][21][22][23][24][25][26][27][28], it remains uncertain whether any of these therapies were able to change the progression of the syndrome. There was no strong evidence for the efficacy of anticoagulant therapy in the acute phase of CWS.…”

Section: Discussionmentioning

confidence: 99%

Capsular Warning Syndrome: Clinical Analysis and Treatment

He

¹

,

Xu²,

Wang

³

et al. 2019

Preprint

0

View full text Add to dashboard Cite

Background: Capsular warning syndrome (CWS) was a rare clinical syndrome, which was defined as recurrent transient lacunar syndromes. The mechanism and clinical management of CWS were not clear. The purpose of this study was to discuss the clinical characteristics, treatment and prognosis of the CWS. Methods: This was a multicenter retrospective study that involved three medical centers, we collected clinical data from patients with CWS between January 2013 and December 2018. We analyzed the clinical characteristics of the CWS. Patients with CWS were divided into two groups: rt-PA and no rt-PA groups. We analyzed the therapeutic effects and prognosis between different groups. Results: This study included 72 patients, 27 in rt-PA group, 45 in no rt-PA group, hypertension and dyslipidemia were the most common risk factors. The mean number of episodes before an irreversible neurological impairment or the symptoms completely disappeared was 5 times(3-11). 59 (81.94%) patients had acute infarction lesions on the diffusion weighted imaging (DWI). The most common infarct location was the internal capsule (76.38%,55), followed by the thalamus and pons. The difference in therapeutic effects between rt-PA, single and double antiplatelet groups was not significant(P>0.05). A good prognosis was observed in 61 (84.72%) patients at 3-month, 23 (23/27, 85.19%) patients in rt-PA group and 38 (38/45,84.44%) patients in no rt-PA group(P>0.05). After 3 months of follow-up, 2 patients had recurrent ischemic stroke. Conclusions: The most effective treatment of CWS remains unclear. Despite the high incidence of infarction in CWS patients, more than 80% patients had favorable functional prognosis

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Very prolonged capsular warning syndrome

Cited by 9 publications

References 10 publications

Capsular warning syndrome: clinical analysis and treatment

Capsular warning syndrome: clinical analysis and treatment

Capsular Warning Syndrome: Clinical Analysis and Treatment

Capsular Warning Syndrome: Clinical Analysis and Treatment

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