title: Conjugate eye deviation in acute intracerebral hemorrhage: stroke acute management with urgent risk-factor assessment and improvement--ICH (SAMURAI-ICH) study.
abstract: OBJECTIVE
  Conjugate eye deviation (CED) occurs frequently in patients with acute stroke. The purpose of this study was to elucidate the factors that correlate with CED as well as the relationship between CED and outcomes in patients with acute intracerebral hemorrhage.
  
  
  METHODS
  A total of 211 patients with acute supratentorial intracerebral hemorrhage were recruited in a multicenter, prospective study. CED was assessed with a National Institutes of Health Stroke Scale "best gaze" subscore of ≥1. Hematoma location and volume were assessed on CT.
  
  
  RESULTS
  Forty-five percent of the patients had CED. On multivariable analysis, right-sided lesion (OR, 2.36; 95% CI, 1.18-4.93), hematoma volume (OR, 1.07; 95% CI, 1.04-1.10 per 1 mL), and baseline Glasgow Coma Scale score (OR, 0.66; 95% CI, 0.53-0.80 per 1 point) were independently associated with CED. After adjusting for sex, age, intraventricular extension of the hematoma, baseline Glasgow Coma Scale score, and hematoma volume, the presence of CED both on admission and 72 hours later was an independent predictor of death or dependency at 3 months poststroke (OR, 5.77; 95% CI, 2.27-16.94). The optimal cutoff volume of hematoma related to CED was ≥13.5 mL for patients with putaminal hemorrhage (sensitivity, 76%; specificity, 72%) and ≥7.7 mL for patients with thalamic hemorrhage (sensitivity, 82%; specificity, 83%).
  
  
  CONCLUSIONS
  The persistence of CED was a significant predictor of death or dependency after acute supratentorial intracerebral hemorrhage even after adjusting for initial severity and hematoma volume. CED can be evoked by a relatively smaller thalamic hematoma than a putaminal hematoma.
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. sato.shoichiro.hp@mail.ncvc.go.jp
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Sato
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Koga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamagami
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okuda
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okada
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kimura
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shiokawa
authors.forename: Jyoji
authors.initials: J
authors.lastname: Nakagawara
authors.forename: Eisuke
authors.initials: E
authors.lastname: Furui
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hasegawa
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
authors.forename: Shoji
authors.initials: S
authors.lastname: Arihiro
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Nagatsuka
authors.forename: Kazuo
authors.initials: K
authors.lastname: Minematsu
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
mesh_terms: D000368:Aged; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D020127:Recovery of Function; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality