Mild neurological symptoms despite middle cerebral artery occlusion.
OBJECTIVE
Only a small percentage of stroke patients are treated with thrombolytic therapy. We sought to determine whether vessel occlusion in mild strokes represented a new target population for interventional therapy.


METHODS
We imaged 106 acute stroke patients with MRI. Patients were identified with evidence of middle cerebral artery (MCA) occlusion and mild or no stroke signs (National Institutes of Health Stroke Scale [NIHSS] <or=3). They were compared with patients with signs of stroke, NIHSS >3, and MCA occlusion.


RESULTS
We identified 5 patients with absent flow on MRA in the MCA and mild or no stroke signs (NIHSS <or=3). All 5 were functionally independent at 3 months.


CONCLUSIONS
Caution should be exercised in considering thrombolytic therapy in these patients. Quantification of perfusion imaging is required to identify "at risk" mild stroke populations.
Coutts
Shelagh B
SB
Department of Clinical Neurosciences, University of Calgary, Alberta T2N 2T9, Canada. shelagh.coutts@calgaryhealthregion.ca
Barber
Philip A
PA
Demchuk
Andrew M
AM
Hill
Michael D
MD
Pexman
J H Warwick
JH
Hudon
Mark E
ME
Buchan
Alastair M
AM
D000208:Acute Disease; D000368:Aged; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology*; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed