Computed tomography in prognostic stroke evaluation.

Rasmussen, Daniel Bech; Köhler, Ole; Worm-Petersen, Søren; Blegvad, N. Rh.; Jacobsen, H L; Bergmann, I; Egeblad, M; Friis, Mogens Laue; Nielsen, N T

doi:10.1161/01.str.23.4.506

Cited by 18 publications

(9 citation statements)

References 26 publications

(7 reference statements)

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“…A similar location of the infarction in all patients allowed analysis of the association between the lesion size and the degree of neurological disability. Computed infarction volumes have been previously shown to possess an important prognostic value in the formation of neurological deficits after stroke, 28 which was also confirmed in this study by use of a new MRI-based technique. Our relatively small study group, however, included both very small and large infarctions, which increased the dispersion of measured variables.…”

Section: Discussionsupporting

confidence: 82%

Low Plasma Antioxidant Activity Is Associated With High Lesion Volume and Neurological Impairment in Stroke

Leinonen

Ahonen²,

Lönnrot³

et al. 2000

Stroke

150

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Background and Purpose-Oxidative stress is probably involved in neuronal damage induced by ischemia-reperfusion.The purpose of this study was to assess the role of antioxidant activity in cerebral ischemic stroke. Methods-Antioxidant activity of blood plasma and cerebrospinal fluid was assessed in 22 patients with cerebral hemisphere infarction that was verified and quantified by MRI. Results-Low total peroxyl radical trapping potential of plasma, but not of cerebrospinal fluid, was associated with high lesion volume and high neurological impairment assessed by scores on NIH Stroke Scale, Barthel Index, and Hand Motor Score tests. The plasma concentrations of ascorbic acid, ␣-tocopherol, and protein thiols were also associated with the degree of neurological impairment. Conclusions-These data suggest that the antioxidant activity of plasma may be an important factor providing protection from neurological damage caused by stroke-associated oxidative stress. (Stroke. 2000;31:33-39.)

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Section: Discussionsupporting

confidence: 82%

Low Plasma Antioxidant Activity Is Associated With High Lesion Volume and Neurological Impairment in Stroke

Leinonen

Ahonen²,

Lönnrot³

et al. 2000

Stroke

150

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“…However, clinical severity of CI was subjectively assessed -probably mild in most cases -and clinical outcome measures were based on subjective comparison between the first and a very early (after 5-11 days) last examination. Rasmussen and col. 25 were also unable to find a significant prognostic impact of lesion size after CI. Eleven percent of their patients, however, had intracranial hemorrhages.…”

Section: Commentsmentioning

confidence: 79%

“…Reports from two groups 14,25 are in apparent disagreement with this view. Both studies, however, may have significant drawbacks.…”

Section: Commentsmentioning

confidence: 93%

The correlation of ct findings and in-hospital mortality after cerebral infarction

André¹,

Pinheiro

1995

Arq. Neuro-Psiquiatr.

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SUMMARY -Objective:To evaluate whether findings on computed tomography (CT) are useful to predict early mortality after acute cerebral infarction. Methods: An admission CT was performed in 98 patients with disease-onset within 7 days; CT findings were analyzed using a checking list; their influence on hospital mortality was studied by logistic regression analysis. Results: There were 29 hospital deaths. Uncal herniation and midline shift>4mm were strongly correlated with fatal outcome. Also associated with increased mortality: infarction of a whole hemisphere or in the distribution of internal carotid artery; massive (>90% expected area) infarction in the territory of the anterior or posterior cerebral arteries; massive or submassive (>50% expected area) middle cerebral artery infarction; large lesion volume (death in 9/13 patients with lesions >50cm 3 ); any degree of mass effect. In 68 patients with single middle cerebral artery lesions, extension of the lesion to adjacent vascular territories was also associated with a worse outcome. The number of lesions and the presence of contrast enhancement, hemorrhagic changes or cerebral atrophy did not influence outcome. Conclusions: CT findings indicating significant mass effect and large infarcts are associated with mortality after ischemic stroke. The best combination of clinical and CT variables to estimate death risk in individual patients remains to be determined.KEYWORDS: cerebral infarction, cerebrovascular disorders, cerebral hernia, mortality, prognosis, CT scan.Correlação entre achados à TC e letalidade hospitalar após infarto cerebral RESUMO -Objetivo: Avaliar a importância dos achados à tomografia computadorizada (TC) na determinação do risco de vida precoce após o infarto cerebral. Métodos: 98 pacientes com infarto cerebral com até 7 dias de evolução foram estudados por TC à admissão; os achados à TC foram avaliados de modo padronizado; a influência destes achados sobre a letalidade hospitalar foi estudada por análise de regressão logística. Resultados: 29 pacientes faleceram durante a internação. Herniação de unco e desvio de estruturas de linha média superior a 4 mm associaram-se fortemente ao risco de vida elevado. Outros fatores positivamente relacionados: infarto hemisférico ou ocupando o território carotídeo (a. cerebral anterior e a. cerebral média); infarto maciço (>90% da área esperada) no território das artérias cerebrais anterior ou posterior; infarto maciço ou submaciço (>50% da área esperada) no território da artéria cerebral média; grande volume de lesão (morte em 9/13 pacientes com lesão >50cm 3 ); qualquer grau de efeito de massa. Em 68 pacientes com lesões únicas no território da artéria cerebral média, a extensão da lesão a territórios vasculares adjacentes também associou-se a pior prognóstico. O número de lesões e a presença de captação de contraste, transformação hemorrágica ou de atrofia cerebral não influenciaram a evolução. Conclusões: Os achados de importante efeito de massa e grandes lesões à TC associamse fortemente a alta leta...

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“…Older patients have higher in-hospital mortality as well as poorer functional outcomes after an ischemic event [14]. Although age is one of the most significant prognostic markers for poor outcome [39], very few studies have been performed in aged animals, especially in animals over 15 months of age. Numerous neurochemical and physiological changes occur with aging [40].…”

Section: Effect Of Age On Modeling Mcaomentioning

confidence: 99%

Middle Cerebral Artery Occlusion Model in Rodents: Methods and Potential Pitfalls

Liu

McCullough

2011

Journal of Biomedicine and Biotechnology

177

152

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A variety of animal models have been developed for modeling ischemic stroke. The middle cerebral artery occlusion (MCAO) model has been utilized extensively, especially in rodents. While the MCAO model provides stroke researchers with an excellent platform to investigate the disease, controversial or even paradoxical results are occasionally seen in the literature utilizing this model. Various factors exert important effects on the outcome in this stroke model, including the age and sex of the animal examined. This paper discusses emerging information on the effects of age and sex on ischemic outcomes after MCAO, with an emphasis on mouse models of stroke.

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Computed tomography in prognostic stroke evaluation.

Cited by 18 publications

References 26 publications

Low Plasma Antioxidant Activity Is Associated With High Lesion Volume and Neurological Impairment in Stroke

Low Plasma Antioxidant Activity Is Associated With High Lesion Volume and Neurological Impairment in Stroke

The correlation of ct findings and in-hospital mortality after cerebral infarction

Middle Cerebral Artery Occlusion Model in Rodents: Methods and Potential Pitfalls

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