Acute ischemic stroke: relationship of brain lesion location & functional outcome.
OBJECTIVE
To establish, using brain spiral computerised tomography (SCT) and modified Barthel index (MBI), whether the location of cerebral infarction could be correlated with functional outcome in acute ischemic stroke patients who undergo early intensive rehabilitation.


METHODS
Observational cohort, assessor blinded and correlational prospective 12-weeks study that included 111 acute ischemic stroke patients, admitted consecutively to an early intensive inpatient rehabilitation programme (5 days a week, 3-5 h a day) during 2003. Confirmation of diagnosis and stratification was done by brain SCT. Brain lesion locations were correlated to motor performance and functional outcome, on admission and discharge, using MBI.


RESULTS
Statistical analysis demonstrated a significant correlation between motor performance, functional outcome and brain lesion locations. The groups with deep, combined deep and large superficial, small superficial and large superficial infarcts showed the most consistent improvement in that order of frequency. Normal brain SCT group did not reach statistical significance (p = 0.051) while the bi-hemispheric infarcts group did not show any change. The inter and intra group differences were highly significant (p < 0.05).


CONCLUSIONS
Immediate non-contrasted brain SCT may act as an independent predictor of final functional outcome in acute ischemic stroke. It may provide clinicians with an opportunity to offer realistic expectations to stroke patients and their relatives.
Nazzal
Mahmoud Ezzat
ME
Department of Allied Medical Sciences, King Abdullah University Hospital, Jordan University of Science and Technology (JUST), Irbid, Jordan.
Saadah
Mohammed Ahmed
MA
Saadah
Loai Mohammed
LM
Trebinjac
Suad Mustafa
SM
D000328:Adult; D000368:Aged; D020520:Brain Infarction / Q000000981:diagnostic imaging* / Q000473:pathology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function; D012720:Severity of Illness Index; D036542:Tomography, Spiral Computed