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Scavasine VC, Stoliar GA, Teixeira BCDA, Zétola VDHF, Lange MC. Automated evaluation of collateral circulation for outcome prediction in acute ischemic stroke. J Stroke Cerebrovasc Dis 2024; 33:107584. [PMID: 38246577 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024] Open
Abstract
INTRODUCTION The assessment of collateral circulation in acute ischemic stroke management is essential. Modern tools, such as Brainomix's e-CTA, powered by artificial intelligence, provide detailed insights into collateral assessment. This retrospective study aims to identify factors contributing to favorable collateral status and compare outcomes between patients with good collaterals (grade 3) and fair collaterals (grade 0-2). METHOD This retrospective study included 97 patients admitted to the Stroke Unit at the Hospital de Clínicas of the Federal University of Paraná, Brazil, from September 2021 to January 2023. Comparative analyses involved demographic factors, cardiovascular risk factors, and the combined outcome of mortality and moderate to severe disability at discharge, 30-day, and 90-day follow-ups. RESULTS Among the 97 cases, 58.8 % showed 'good collaterals' with a grade 3 status. Variables affecting collateral status included age (p = 0.042), neutrophil-lymphocyte ratio (p = 0.005), and initial NIHSS scores (p<0.001). The presence of good collaterals according to e-CTA reduced the odds of death and moderate-severe disability at discharge (p = 0.003; OR 0.27) and at 30 days (p = 0.015; OR 0.33), although this effect diminished at the 90-day mark after multivariate analysis. DISCUSSION Automated collateral assessment through e-CTA is a valuable tool in acute ischemic stroke evaluation. Good e-CTA collateral score serve as a promising imaging biomarker, guiding informed clinical decisions during Stroke Unit hospitalizations. This study highlights the relationship between collaterals and stroke outcomes and underscores the potential for AI-driven tools to enhance stroke care management.
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Affiliation(s)
| | - Gabriel Abrahao Stoliar
- Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | | | - Marcos Christiano Lange
- Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
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Scavasine VC, Costa RT, Zétola VDHF, Lange MC. IScore, a useful prognostic tool for patients with acute ischemic stroke treated with intravenous thrombolysis: a validation study. Arq Neuropsiquiatr 2023; 81:107-111. [PMID: 36948196 PMCID: PMC10033190 DOI: 10.1055/s-0042-1758397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Stroke is one of the major causes of disability and mortality worldwide. Up to 30% of individuals who experience stroke die within 30 days, and more than 50% of those who survive will have some degree of disability. There are some predetermining factors based on admission data that could be used to objectively assess the odds of poor outcomes, including the Ischemic Stroke Predictive Risk Score (IScore). OBJECTIVE To analyze and validate the IScore in patients undergoing intravenous thrombolysis for stroke and compare the results of this predictor with actual death and disability outcomes. METHODS In a retrospective study, data were collected from a database housed at the Stroke Unit of the Teaching Hospital of Universidade Federal do Paraná, Southern Brazil. The IScore was applied to admission data from 239 patients, and the results were compared with actual outcomes (death and disability) within 30 days and 1 year after the stroke event. Data analysis was performed using an analysis of the receiver operating characteristic (ROC) curve to determine the sensitivity and specificity of the IScore in the study population. RESULTS The IScore demonstrated moderate sensitivity and high specificity in patients with stroke who underwent thrombolysis when evaluated after 30 days and 1 year of the event. CONCLUSIONS The IScore can be applied to in stroke patients undergoing thrombolysis; therefore, it may be used as an objective prognostic tool to guide clinical decision-making. Understanding the prognosis of patients in the acute phase can assist clinicians in making the best therapeutic decisions and enable better end-of-life care.
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Affiliation(s)
| | - Rebeca Teixeira Costa
- Universidade Federal do Paraná, Hospital de Clínicas, Divisão de Neurologia, Curitiba PR, Brasil
| | | | - Marcos Christiano Lange
- Universidade Federal do Paraná, Hospital de Clínicas, Divisão de Neurologia, Curitiba PR, Brasil
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Scavasine VC, Ferreti LA, da Costa RT, Leitao CA, Teixeira BC, Zétola VDHF, Lange MC. Automated evaluation of ASPECTS from brain computerized tomography of patients with acute ischemic stroke. J Neuroimaging 2023; 33:134-137. [PMID: 36307385 DOI: 10.1111/jon.13066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/21/2022] [Accepted: 10/18/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Precise evaluation of brain computerized tomography (CT) is a crucial step in acute ischemic stroke evaluation. Electronic Alberta Stroke Program Early CT Score (E-ASPECTS) helps in the selection of patients who may be eligible for thrombolysis. This paper seeks to assess the performance of emergency physicians (EPs) in the evaluation of ASPECTS scores with and without the use of E-ASPECTS and to compare their results with neuroradiologists. METHODS A total of 116 patients were selected. Initially, two EPs and two neuroradiologists evaluated the admission nonenhanced CT without E-ASPECTS. Then, after 30 days, they re-evaluated the images using E-ASPECTS. Sensitivity, specificity, Matthew's correlation coefficients (MCC), and receiver operating characteristic curves were generated for analysis before and after the software use. RESULTS Eps' performances improved when they used E-ASPECTS, with their results closer to those obtained by neuroradiologists. In the initial evaluation, MCC values for the two EPs were -0.01 and 0.04, respectively. After the software assistance, they obtained 0.38 and 0.43, respectively, which was closer to the scores obtained by the neuroradiologists (0.53 and 0.39, respectively). DISCUSSION This is the first study that has specifically compared neuroradiologists' and EPs' performances before and after using E-ASPECTS. E-ASPECTS assisted and improved the evaluation of the images of patients with acute ischemic stroke. CONCLUSION Artificial intelligence in the emergency room may increase the number of patients treated with tissue-type plasminogen activators.
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Affiliation(s)
| | - Lucas Andrade Ferreti
- Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | | | - Cleverson Alex Leitao
- Radiology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
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Scavasine VC, Chamma JF, Bazan R, Braga GP, Lange MC, Zétola VDHF. Comparison of right-to-left shunt characteristics in cryptogenic embolic ischemic stroke and non-cardioembolic ischemic stroke. Arq Neuropsiquiatr 2021; 79:859-863. [PMID: 34706014 DOI: 10.1590/0004-282x-anp-2020-0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 12/07/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Patent foramen ovale (PFO) has been considered a potential mechanism of embolic stroke of undetermined origin. OBJECTIVE The aim of the present study was to identify the features of the right-to-left shunt (RLS) in patients with undetermined embolic ischemic stroke and compare them with those of patients with non-cardioembolic ischemic stroke. METHODS A retrospective study was conducted with 168 patients with stroke and RLS separated into the following two groups: the undetermined embolic stroke group (UES group) and non-cardioembolic stroke group (NCES group). All patients were assessed by transcranial Doppler to evaluate the presence and quantification of microembolic signals (MES) at rest and under Valsalva maneuver. RESULTS Of all patients evaluated in the current study, 96 were included in the UES group and 72 in the NCES group. In the UES group, 65 patients had RLS with ≥10 MES (67.7%), which was higher than that observed in the NCES group (51.4%, p=0.038). According to the moment of the cardiac cycle, 75 patients (78.1%) in the UES group had a positive test at rest compared to 42 (58.3%) in the NCES group (p=0.007). CONCLUSIONS The current study demonstrated that almost 70% of patients with undetermined embolic stroke and PFO presented a large RLS and more than 75% had RLS at rest. These findings suggest that the size of the shunt should be taken into account when evaluating whether PFO could be a possible mechanism underlying cryptogenic stroke.
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Affiliation(s)
| | - Jamileh Ferreira Chamma
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brazil
| | - Rodrigo Bazan
- Universidade Estadual Paulista "Júlio de Mesquita Filho", Departamento de Neurologia, Botucatu SP, Brazil
| | - Gabriel Pereira Braga
- Universidade Federal de Mato Grosso do Sul, Departamento de Neurologia, Campo Grande MS, Brazil
| | - Marcos Christiano Lange
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brazil
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Scavasine VC, Ribas GDC, Costa RT, Ceccato GHW, Zétola VDHF, Lange MC. Embolic Stroke of Undetermined Source (ESUS) and Stroke in Atrial Fibrillation Patients: not so Different after all? International Journal of Cardiovascular Sciences 2021. [DOI: 10.36660/ijcs.20190191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Ferreira MG, Scavasine VC, Breda GL, Almeida BMMD, Zétola VDHF, Lange MC. Small vessel occlusion and syphilis in patients with first-ever ischemic stroke. Arq Neuropsiquiatr 2021; 79:103-106. [PMID: 33759975 DOI: 10.1590/0004-282x-anp-2020-0178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 07/07/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Syphilis is an endemic disease, particularly in low- and middle-income countries, with vascular involvement in large vessels (aortitis), but no clear relationship with stroke patients, except for those who presented with meningovascular neurosyphilis. OBJECTIVE To investigate the relationship between a positive history of syphilis determined by serological testing and ischemic stroke etiology, particularly small vessel disease (SVD). METHODS In total, 269 first-ever ischemic stroke patients admitted to the stroke unit were tested for syphilis. Patients with neurosyphilis were excluded. All patients were classified according to the ASCOD phenotyping as SVD - when SVD was the potential causal mechanism (S1) - or non-SVD - when SVD was uncertain (S2), unlike (S3), or not detected (S0). RESULTS Syphilis was positive in 32 (12%) patients. When comparing patients with positive and negative serology, the only significant difference was SVD as the causal mechanism (S1) in patients with positive results: 9 (28%) vs. 22 (9%), p<0.01. CONCLUSION The current study showed that the frequency of positive syphilis serological test was higher in patients with first-ever ischemic stroke and SVD as the potential causal mechanism. This finding could be related to the endothelial dysfunction occurring in syphilis.
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Affiliation(s)
- Matheus Gomes Ferreira
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brazil
| | | | - Giovanni Luís Breda
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Doenças Infecciosas, Curitiba PR, Brazil
| | | | | | - Marcos Christiano Lange
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brazil
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Lange MC, Ribas G, Scavasine V, Ducci RDP, Mendes DC, Zétola VDHF, Cabral N, Rundek T. Stroke recurrence in the different subtypes of ischemic stroke. The importance of the intracranial disease. Arq Neuropsiquiatr 2019; 76:649-653. [PMID: 30427503 DOI: 10.1590/0004-282x20180095] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 06/26/2018] [Indexed: 11/22/2022]
Abstract
The aim of the study was to analyze the long-term recurrence rate in patients with a first-ever ischemic stroke secondary to intracranial large artery atherosclerosis (LAA) in a Brazilian population. METHODS All stroke patients admitted to the hospital between October 2012 and September 2015 were evaluated. The stroke mechanism subtypes were classified as cardioembolism, LAA, small-vessel occlusion, other determined etiologies, and stroke of undetermined etiology. RESULTS The 359 first-ever ischemic stroke patients were followed up for a mean time of 21.6 ± 15.1 months. The LAA intracranial (38.9%) and extracranial (24.6%) stroke patients presented with a higher stroke recurrence. Intracranial LAA [HR, 10.2 (3.6-29.1); p < 0.001] and extracranial LAA [HR, 5.05 (1.79-14.2); p = 0.002] were the only conditions to show positive correlation with the recurrence rate, after adjusting for risk factors, thrombolysis, and National Institutes of Health Stroke Scale score at admission. CONCLUSION Intracranial LAA presents a higher incidence of recurrence of ischemic stroke when compared with other etiologies in a Southern Brazilian population.
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Affiliation(s)
- Marcos C Lange
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brasil
| | - Gustavo Ribas
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brasil
| | - Valeria Scavasine
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brasil
| | - Renata Dal-Prá Ducci
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brasil
| | - Danielle C Mendes
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Neurologia, Curitiba PR, Brasil
| | | | - Norberto Cabral
- Universidade da Região de Joinville, Departamento de Medicina, Joinville SC, Brasil
| | - Tatjana Rundek
- University of Miami, Miller School of Medicine, Department of Neurology, Miami, FL, USA
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Gatto LAM, Koppe GL, Demartini Z, Zétola VDHF. Physicians are not well informed about the new guidelines for the treatment of acute stroke. Arq Neuropsiquiatr 2017; 75:718-721. [PMID: 29166463 DOI: 10.1590/0004-282x20170122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 07/12/2017] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Treatment of cerebrovascular disease has advanced rapidly in the last two decades. Recent data has added challenges to the treatment of ischemic stroke in the acute phase. OBJECTIVE To evaluate the knowledge of physicians about the treatment of ischemic stroke in the acute phase. METHODS An online questionnaire was submitted to all physicians enrolled in the Regional Council of Medicine in Brazil. RESULTS 456 physicians from different specialties answered the questions. Most of them did not know that mechanical endovascular thrombectomy is often considered as the gold standard treatment in cases of ischemic stroke in the acute phase; and 85% of them did not realize that thrombectomy together with intravenous thrombolysis was possible. The maximum time to act in an acute event also presented many divergences, even with regard to the infusion of rtPA. The lack of structure, medication and absence of a neurologist were considered the main barriers to treatment. CONCLUSION Physicians are not well informed about the new guidelines for the treatment of acute stroke. Most physicians incorrectly answered most of the questions on the questionnaire.
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Affiliation(s)
- Luana Antunes Maranha Gatto
- Pontifícia Universidade Católica do Paraná, Hospital Universitário Cajuru, Departamento de Neurocirurgia, Curitiba PR, Brasil.,Pontifícia Universidade Católica do Paraná, Hospital Universitário Cajuru, Departamento de Neurorradiologia Intervencionista, Curitiba PR, Brasil
| | - Gelson Luis Koppe
- Pontifícia Universidade Católica do Paraná, Hospital Universitário Cajuru, Departamento de Neurorradiologia Intervencionista, Curitiba PR, Brasil
| | - Zeferino Demartini
- Pontifícia Universidade Católica do Paraná, Hospital Universitário Cajuru, Departamento de Neurocirurgia, Curitiba PR, Brasil.,Pontifícia Universidade Católica do Paraná, Hospital Universitário Cajuru, Departamento de Neurorradiologia Intervencionista, Curitiba PR, Brasil
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Affiliation(s)
- Renata Dal-Prá Ducci
- Department of Neurology, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
| | - Marcos Christiano Lange
- Department of Neurology, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil
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Ducci RDP, Lange MC, Zétola VDHF. Predictors of in-hospital mortality and dependence at discharge in patients with MCA stroke with intravenous thrombolysis. Intern Emerg Med 2017; 12:453-460. [PMID: 28028726 DOI: 10.1007/s11739-016-1590-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/10/2016] [Indexed: 10/20/2022]
Abstract
Early risk stratification of mortality and dependence is important for guiding medical decision-making in stroke care. The study aim is to evaluate whether there are any differences between risk factors for in-hospital mortality and dependence at discharge in patients with first-episode ischemic stroke in the middle cerebral artery (MCA) receiving intravenous thrombolysis (IVT) treatment. The study comprised a single-center cohort of patients admitted consecutively for first-episode MCA ischemic stroke. A logistic regression analysis was performed to determine the variables associated with in-hospital mortality and dependence at discharge. We included 169 patients (50.9% women) with a mean age of 64.1 ± 12.9 years and a median National Institute of Health Stroke Scale (NIHSS) score of 13 (range 3-26) at admission. Nineteen patients (11.2%) died as inpatients [the main cause of death was found to be infection (47.4%)]. The independent predictors for in-hospital mortality were: age (OR 1.09, 95% CI 1.03-1.15, p = 0.004) and NIHSS score (>17) at admission (OR 1.17, 95% CI 1.05-1.30, p = 0.004). Two other crude models used to analyze in-hospital mortality (age and symptoms-to-needle time, and age and symptomatic intracerebral hemorrhage) were significant. NIHSS score (>11) at admission (OR 1.29, 95% CI 1.17-1.42, p < 0.001) and large artery atherosclerosis stroke (OR 3.10, 95% CI 1.10-8.76, p = 0.031) were independently associated with dependence at discharge. Overall, the predictors for mortality and dependence in patients with first-episode MCA ischemic stroke treated with IVT were different. This knowledge might help to improve the management of this devastating disease.
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Affiliation(s)
- Renata Dal-Prá Ducci
- Department of Neurology, Hospital de Clínicas, Serviço de Neurologia, Universidade Federal do Paraná, Rua General Carneiro, 181-4º andar, Curitiba, PR, 80060-900, Brazil.
| | - Marcos Christiano Lange
- Department of Neurology, Hospital de Clínicas, Serviço de Neurologia, Universidade Federal do Paraná, Rua General Carneiro, 181-4º andar, Curitiba, PR, 80060-900, Brazil
| | - Viviane de Hiroki Flumignan Zétola
- Department of Neurology, Hospital de Clínicas, Serviço de Neurologia, Universidade Federal do Paraná, Rua General Carneiro, 181-4º andar, Curitiba, PR, 80060-900, Brazil
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Ducci RDP, Lange MC, Zétola VDHF, Rundek T. Factors Related to Cardioembolism as Major Predictors of Poor Survival after First-Ever Middle Cerebral Artery Stroke Treated with Thrombolysis. Cerebrovasc Dis 2017; 43:178-185. [DOI: 10.1159/000455723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 12/30/2016] [Indexed: 12/27/2022] Open
Abstract
<b><i>Background and Purpose:</i></b> Prognostic factors related to mortality rates after stroke have been reported; however, most studies included different treatments and did not focus solely on ischemic stroke. The study aimed to report the short- and long-term survival and predictors of death in patients with first-ever ischemic stroke in the middle cerebral artery (MCA) territory, submitted to intravenous thrombolysis (IVT). <b><i>Methods:</i></b> A prospective observational cohort study of patients with first-ever ischemic stroke in the MCA territory treated with IVT from March 2010 to February 2015 was conducted, and patients were followed up until May 2015. The Kaplan-Meier method was used to estimate the cumulative case fatality rates. The potential prognostic factors were identified using Cox proportional hazards regression analysis. <b><i>Results:</i></b> A total of 169 patients, 51% women of mean age of 64.1 ± 12.9 years were followed up for a median time of 23.6 (8.1-36.2) months. At the end of the study, 53 (31.4%) patients had died. The estimated cumulative case fatality rate was 41.8% for 5 years. Chronic heart failure (hazards ratio [HR] 2.89, 95% CI 1.43-5.84, <i>p</i> = 0.003), atrial fibrillation (HR 3.88, 95% CI 1.30-11.57, <i>p</i> = 0.015), and symptomatic intracerebral hemorrhage (SICH; HR 7.83, 95% CI 3.43-17.92, <i>p</i> < 0.001) were significant unfavorable independent outcome predictors. The most frequent cause of death was infection (46%). <b><i>Conclusions:</i></b> Stroke in the MCA territory has a high mortality rate, even in patients treated with IVT. SICH, atrial fibrillation, and chronic heart failure are modifiable factors related to cardioembolism that need to be aggressively targeted for improved outcomes after stroke.
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Ducci RDP, Lange MC, Moro CH, Harger R, Longo AL, Cabral NL, Germiniani FMB, Nóvak EM, Zétola VDHF. Does the side of middle cerebral artery compromise matters in the mortality after thrombolysis in ischemic stroke? Arq Neuropsiquiatr 2015. [PMID: 26222353 DOI: 10.1590/0004-282x20150079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
UNLABELLED The impact of the side in middle cerebral artery (MCA) ischemic stroke is not well established. Our aim was to analyze the differences between right (RMCA) and left middle cerebral artery (LMCA) stroke in patients submitted to intravenous thrombolysis and the influence of the affected side in the patient's mortality after 3 months. METHOD Patients with MCA ischemic stroke submitted to intravenous thrombolysis from March 2010 to December 2011 at two Brazilian Stroke Centers were included. Differences between patients with RMCA and LMCA stroke were identified by univariate analysis. RESULTS Forty-five patients with RMCA stroke and 67 with LMCA stroke were analyzed. Patients with LMCA had a higher incidence of atrial fibrillation (p = 0.031), although patients with RMCA more often had a previous ischemic stroke (p = 0.034). The mortality over 3 months was similar for either side (OR = 1.20 ;0.37 - 4.29, p = 0.772). CONCLUSION The side of the MCA ischemic stroke did not influence the patients mortality.
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Affiliation(s)
- Renata Dal-Prá Ducci
- Departamento de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Marcos Christiano Lange
- Departamento de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Carla Heloísa Moro
- Departamento de Neurologia, Hospital Municipal São José, Joinville, SC, Brazil
| | - Rodrigo Harger
- Departamento de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | | | | | - Edison Matos Nóvak
- Departamento de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
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Zétola VDHF. Peripheral neuropathy investigation in the early stage of bone marrow transplantation. Arq Neuro-Psiquiatr 1997. [DOI: 10.1590/s0004-282x1997000300026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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