title: Glasgow coma scale does not predict outcome post-intra-arterial treatment for basilar artery thrombosis.
abstract: OBJECTIVE
  Evidence to guide patient selection for IA therapy in acute basilar artery thrombosis is lacking. The GCS is frequently used as a selection criterion, based on the view that higher GCS correlates with better neurologic outcome. This view has not been systematically studied. We hypothesize that low GCS does not correlate with poor outcome and that it should not preclude IA therapy.
  
  
  METHODS
  We included 40 consecutive patients with basilar artery thrombosis treated with IA therapy. Clinical characteristics, GCS, time to intervention, and postprocedural TIMI scores were collected. Recanalization was defined as TIMI grade 2 or 3; clinical outcome was measured by 90-day mRS.
  
  
  RESULTS
  Median patient age was 63.5 years. Most presented with gaze palsies (67.5%) or hemiparesis (45%). Median GCS was 9, the median time to intervention was 7.2 hours, and recanalization rate was 82.5%. Good neurologic outcome (mRS ≤ 1) occurred in 30%. There was no correlation between GCS and 90-day mRS (Spearman ρ - 0.174, P = .283). Equal numbers of patients with good neurologic outcome of mRS ≤ 1 (n = 12) had a GCS of ≤6 or >6. In those with GCS ≤ 6 for >3 hours, 33.3% had good neurologic outcome-a similar rate to that of the overall cohort. Statistical significance was demonstrated between time to IA therapy within 6 hours and mRS ≤ 2.
  
  
  CONCLUSIONS
  Low GCS score did not correlate with poor neurologic outcome in patients with acute basilar artery thrombosis managed with IA therapy. It is not appropriate to exclude patients from IA therapy on the basis of low GCS.
authors.affiliation: Department of Radiology, The Royal Melbourne Hospital, Australia.
authors.forename: R V
authors.initials: RV
authors.lastname: Chandra
authors.forename: C P
authors.initials: CP
authors.lastname: Law
authors.forename: B
authors.initials: B
authors.lastname: Yan
authors.forename: R J
authors.initials: RJ
authors.lastname: Dowling
authors.forename: P J
authors.initials: PJ
authors.lastname: Mitchell
mesh_terms: D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015912:Thrombolytic Therapy / Q000379:methods*; D013927:Thrombosis / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000628:therapy*