Outcome of acute stroke patients without visible occlusion on early arteriography

Arnold, Marcel; Nedeltchev, Krassen; Brekenfeld, Caspar; Fischer, Urs; Remonda, Luca; Schroth, Gerhard; Mattle, Heinrich (2004). Outcome of acute stroke patients without visible occlusion on early arteriography. Stroke, 35(5), pp. 1135-8. Baltimore, Md.: Lippincott Williams & Wilkins 10.1161/01.STR.0000125862.55804.29

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BACKGROUND: The aim of this study was to determine the clinical and radiological outcome of acute stroke patients who had no vessel occlusion on arteriography and to define predictors of clinical outcome. METHODS: We analyzed clinical and radiological data of stroke patients whose arteriography performed within 6 hours of symptom onset did not visualize any vessel occlusion. RESULTS: Twenty-eight of 283 consecutive patients (10%) who underwent arteriography with the intention to perform intraarterial thrombolysis did not show any arterial occlusion. Their median baseline National Institutes of Health Stroke Scale (NIHSS) score was 7. Time from symptom onset to arteriography ranged from 115 to 315 minutes; on average, it was 226 minutes. Presumed stroke cause was cardiac embolism in 11 patients (39%), small artery disease in 6 (21%), coronary angiography in 1 (4%), and undetermined in 10 patients (36%). After 3 months, modified Rankin Scale score (mRS) was < or =2 in 21 patients (75%), indicating a favorable outcome. Six patients (21%) had a poor outcome (mRS 3 or 4) and 1 patient (4%) had a myocardial infarction and died. Twenty-seven patients had follow-up brain imaging. It was normal in 5, showed a lacunar lesion in 8, a striatocapsular infarct in 2, a small or medium-sized anterior circulation infarct in 6, multiple small anterior circulation infarcts in 2, and multiple posterior circulation infarcts in 4. No predictors of clinical outcome were identified. CONCLUSIONS: Most acute stroke patients with normal early arteriography show infarcts on brain imaging; however, clinical outcome is usually favorable.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
UniBE Contributor:	Fischer, Urs Martin
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0039-2499
ISBN:	15073404
Publisher:	Lippincott Williams & Wilkins
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 15:05
Last Modified:	02 Mar 2023 23:22
Publisher DOI:	10.1161/01.STR.0000125862.55804.29
PubMed ID:	15073404
Web of Science ID:	000220987800021
URI:	https://boris.unibe.ch/id/eprint/28425 (FactScience: 120710)