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Predictors of good prognosis in total anterior circulation infarction within 6 h after onset under conventional therapy

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Tei H, Uchiyama S, Usui T. Predictors of good prognosis in total anterior circulation infarction within 6 h after onset under conventional therapy.

Acta Neurol Scand 2006: 113: 301–306.

© 2006 The Authors Journal compilation © 2006 Blackwell Munksgaard. Objective – 

We investigated the predictors of good prognosis in total anterior circulation infarction (TACI), under conventional therapy. Methods – 

We enrolled 166 patients with first-ever ischemic stroke within 6 h after onset with symptoms of TACI. Sixty-three patients (38.0%) with good outcome [G group, the modified Rankin Disability Scale (mRS) after 3 months ≤3] and 103 patients (62.0%) with bad outcome (B group, mRS >3) were compared. Results – 

On univariate analysis, G group patients were significantly younger, had lower score in the National Institutes of Health Stroke Scale (NIHSS) of total and consciousness sub-score, had lower rate of clinical deterioration. On cranial CT at entry, three early CT signs [hyperdense middle cerebral artery (MCA) sign, hypodensity of >1/3 MCA and brain swelling] were significantly more frequent in the B group. On the second CT at 24–48 h, infarct area as assessed by the Alberta Stroke Programme Early CT Score (ASPECTS) was significantly smaller in the G group. Multivariate analysis with logistic regression revealed age<70 years, NIHSS≤15, no clinical deterioration, and only no brain swelling in early CT signs, and ASPECTS≥7 as independent predictors of good prognosis. Conclusions – 

Some clinical variables are useful in predicting outcome in TACI within the early period after stroke onset.
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Keywords: brain infarction; stroke outcome; total anterior circulation infarction

Document Type: Research Article

Affiliations: 1: Department of Neurology, Toda Central General Hospital, Toda City, Saitama, Japan 2: Department of Neurology, Neurological Institute, Tokyo Women's Medical University, Tokyo, Japan

Publication date: 2006-05-01

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