Predictors of good prognosis in total anterior circulation infarction within 6 h after onset under conventional therapy.
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 < or =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 <7 0 years, NIHSS < or =15, no clinical deterioration, and only no brain swelling in early CT signs, and ASPECTS > or =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.
Tei
H
H
Department of Neurology, Toda Central General Hospital, Toda City, Saitama, Japan. hideaki-tei@m5.dion.ne.jp
Uchiyama
S
S
Usui
T
T
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D020520:Brain Infarction / Q000188:drug therapy* / Q000473:pathology; D004185:Disability Evaluation; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors