title: Discrepancy between early neurological course and mid-term outcome in older stroke patients after mechanical thrombectomy.
abstract: BACKGROUND
  Stroke in aged patients has a relatively poor prognosis, even after recanalizing therapy. Potential reasons include mechanisms that relate directly to the extent of brain tissue damage, but also age-dependent factors which are not, or only indirectly, stroke-related, such as pre-existing functional deficits, comorbidities, and post-stroke complications (eg, infections).
  
  
  OBJECTIVE
  To compare early neurological course with subsequent functional outcome in older (≥80 years) and younger stroke patients in order to estimate the relative impact of these factors. Specifically, to examine if the strong age-dependency of modified Rankin Scale (mRS) outcome scores in stroke patients after mechanical thrombectomy is paralleled by a similar age dependency of early postinterventional National Institute of Health Stroke Scale (NIHSS) scores-a more specific measure of stroke-induced brain damage.
  
  
  METHODS
  We evaluated technical results, pre- and postinterventional NIHSS scores, mid-term mRS scores and early and overall mortality and their relation to age in 125 patients, 40 of them ≥80 years, with acute middle cerebral artery occlusion, treated by mechanical thrombectomy.
  
  
  RESULTS
  Technical success, pre- and postinterventional NIHSS scores and early mortality were age-independent. Early neurological improvement depended on successful recanalization, but not on age. Nevertheless, good mRS outcome (mRS 0-2) was much rarer, and overall mortality almost threefold higher in aged patients.
  
  
  CONCLUSIONS
  Older patients exhibit a similar early neurological course and responsiveness to mechanical thrombectomy as younger patients, but this is not reflected in mid-term functional outcome scores. This indicates that post-stroke complications and other factors that are not, or only indirectly, related to the brain tissue damage induced by the incident stroke have a dominant role in their poor prognosis.
authors.affiliation: Department of Neuroradiology, Technische Universität München, Klinikum Rechts der Isar, München, Germany.
authors.forename: Justus F
authors.identifier: http://orcid.org/0000-0002-2803-075X
authors.initials: JF
authors.lastname: Kleine
authors.affiliation: Department of Neuroradiology, Technische Universität München, Klinikum Rechts der Isar, München, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Boeckh-Behrens
authors.affiliation: Department of Neuroradiology, Technische Universität München, Klinikum Rechts der Isar, München, Germany.
authors.forename: Sascha
authors.identifier: http://orcid.org/0000-0002-3964-3885
authors.initials: S
authors.lastname: Prothmann
authors.affiliation: Department of Neuroradiology, Technische Universität München, Klinikum Rechts der Isar, München, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Zimmer
authors.affiliation: Department of Neuroradiology, Universitätsklinik Köln, Köln, Germany.
authors.forename: Thomas
authors.identifier: http://orcid.org/0000-0001-5640-7780
authors.initials: T
authors.lastname: Liebig
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000601:surgery; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology* / Q000401:mortality; D011379:Prognosis; D015607:Stents; D020521:Stroke / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D016896:Treatment Outcome
keywords: Brain; Intervention; Stroke; Thrombectomy; Thrombolysis