MRI-based score for acute basilar artery thrombosis.
BACKGROUND
Intra-arterial thrombolysis may reduce mortality in acute basilar artery (BA) occlusion. We wanted to identify an easy-to-use pre-treatment MR-based predictor of clinical outcome in patients with acute BA occlusion treated with IAT.


METHODS
We analyzed 16 patients with acute BA occlusion prospectively. Vascular risk factors, as well as National Institutes of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS) scores were recorded on admission, together with a 10-point semiquantitative score reflecting the number of acute ischaemic brain lesions on diffusion-weighted imaging. The recanalization grade was evaluated by angiography. The clinical outcome, using the modified Rankin scale (mRs), was measured 3 months later.


RESULTS
Risk factors, NIHSS and GCS scores, time from symptom onset to treatment, recanalization rate, outcome and outcome predictors (such as age, NIHSS and GCS scores) were comparable to other studies. Haemorrhagic transformation of infarction occurred in 2 patients (12.5%). We found that a high lesion score was an additional predictor of poor outcome (p = 0.026).


CONCLUSIONS
In patients with acute BA occlusion, treated with intra-arterial recombinant tissue plasminogen activator, a high number of acute ischaemic lesions, based on diffusion-weighted imaging, is a predictor of poor clinical outcome.
Renard
D
D
Department of Neurology, Hôpital Gui de Chauliac, CHU Montpellier, Montpellier, France. dimitrirenard@hotmail.com
Landragin
N
N
Robinson
A
A
Brunel
H
H
Bonafe
A
A
Heroum
C
C
Milhaud
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000188:drug therapy*; D001488:Basilar Artery / Q000473:pathology*; D020526:Brain Stem Infarctions / Q000175:diagnosis / Q000209:etiology; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000209:etiology; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D010959:Tissue Plasminogen Activator