Progressing Neurological Deficit Secondary to Acute Ischemic Stroke

Identification of Modifiable and Nonmodifiable Risk Factors for Neurologic Deterioration after Acute Ischemic Stroke

“…reported that a greater proportion of patients with territorially distributed and internal border zone (periventricular white matter) infarcts experienced an “unstable hospital course” (fluctuating or worsening neurological status), compared to patients with purely cortical involvement on diffusion-weighted imaging. (26) Contrary to this and other reports,(27) we observed a higher proportion of patients with ND had experienced cortical infarctions, rather than solely sub-cortical or cerebellar infarctions. However, our study is limited in the fact that we did not distinguish infarct locations using the 6 different lesion patterns as described by Bang et al .…”

Identification of Modifiable and Nonmodifiable Risk Factors for Neurologic Deterioration after Acute Ischemic Stroke

“…reported that a greater proportion of patients with territorially distributed and internal border zone (periventricular white matter) infarcts experienced an “unstable hospital course” (fluctuating or worsening neurological status), compared to patients with purely cortical involvement on diffusion-weighted imaging. (26) Contrary to this and other reports,(27) we observed a higher proportion of patients with ND had experienced cortical infarctions, rather than solely sub-cortical or cerebellar infarctions. However, our study is limited in the fact that we did not distinguish infarct locations using the 6 different lesion patterns as described by Bang et al .…”

Neurological Deterioration in Acute Ischemic Stroke

“…However, interestingly, we found a predictive profile of deterioration over the initial 24 hours after stroke onset that shares risk factors with those of other studies of less selected populations. [2][3][4][5] Nevertheless, in contrast to previous reports, 2,3 initial serum glucose levels were not related to progression of stroke after adjusting for the concomitant history of diabetes, which instead was indicated to be a predictor of progression. Diabetic microangiopathy that leads to chronic impairment of cerebral autoregulation and insufficient cerebral perfusion pressure might, at least in part, explain this finding.…”

Steno-Occlusive Arterial Disease and Early Neurological Deterioration in Acute Ischemic Stroke

“…It is noteworthy that the risk of END was similar in all arterial territories evaluated, but for a higher risk in the VB system. This observation agrees with the well-known higher risk of neurological deterioration in this territory [2,3,4,5,6,7,8,9]. …”

“…The rate of END in our study was 16.3%, similar to the END rates in previous studies that ranged from 13.9 to 32.2% [1,2,3,4,5,6,7,8,9], which can be explained by the diverse criteria used to evaluate the clinical worsening. Our definition of END was based on an increase in the NIHSS score of ≥4 points in the first 72 h, a restrictive criteria less influenced by subjective observations.…”

Identification of Modifiable and Nonmodifiable Risk Factors for Neurologic Deterioration after Acute Ischemic Stroke

“…reported that a greater proportion of patients with territorially distributed and internal border zone (periventricular white matter) infarcts experienced an “unstable hospital course” (fluctuating or worsening neurological status), compared to patients with purely cortical involvement on diffusion-weighted imaging. (26) Contrary to this and other reports,(27) we observed a higher proportion of patients with ND had experienced cortical infarctions, rather than solely sub-cortical or cerebellar infarctions. However, our study is limited in the fact that we did not distinguish infarct locations using the 6 different lesion patterns as described by Bang et al .…”

Neurological Deterioration in Acute Ischemic Stroke

“…However, interestingly, we found a predictive profile of deterioration over the initial 24 hours after stroke onset that shares risk factors with those of other studies of less selected populations. [2][3][4][5] Nevertheless, in contrast to previous reports, 2,3 initial serum glucose levels were not related to progression of stroke after adjusting for the concomitant history of diabetes, which instead was indicated to be a predictor of progression. Diabetic microangiopathy that leads to chronic impairment of cerebral autoregulation and insufficient cerebral perfusion pressure might, at least in part, explain this finding.…”

Steno-Occlusive Arterial Disease and Early Neurological Deterioration in Acute Ischemic Stroke

“…It is noteworthy that the risk of END was similar in all arterial territories evaluated, but for a higher risk in the VB system. This observation agrees with the well-known higher risk of neurological deterioration in this territory [2,3,4,5,6,7,8,9]. …”

“…The rate of END in our study was 16.3%, similar to the END rates in previous studies that ranged from 13.9 to 32.2% [1,2,3,4,5,6,7,8,9], which can be explained by the diverse criteria used to evaluate the clinical worsening. Our definition of END was based on an increase in the NIHSS score of ≥4 points in the first 72 h, a restrictive criteria less influenced by subjective observations.…”

Identification of Modifiable and Nonmodifiable Risk Factors for Neurologic Deterioration after Acute Ischemic Stroke

“…reported that a greater proportion of patients with territorially distributed and internal border zone (periventricular white matter) infarcts experienced an “unstable hospital course” (fluctuating or worsening neurological status), compared to patients with purely cortical involvement on diffusion-weighted imaging. (26) Contrary to this and other reports,(27) we observed a higher proportion of patients with ND had experienced cortical infarctions, rather than solely sub-cortical or cerebellar infarctions. However, our study is limited in the fact that we did not distinguish infarct locations using the 6 different lesion patterns as described by Bang et al .…”

Neurological Deterioration in Acute Ischemic Stroke

“…However, interestingly, we found a predictive profile of deterioration over the initial 24 hours after stroke onset that shares risk factors with those of other studies of less selected populations. [2][3][4][5] Nevertheless, in contrast to previous reports, 2,3 initial serum glucose levels were not related to progression of stroke after adjusting for the concomitant history of diabetes, which instead was indicated to be a predictor of progression. Diabetic microangiopathy that leads to chronic impairment of cerebral autoregulation and insufficient cerebral perfusion pressure might, at least in part, explain this finding.…”

Steno-Occlusive Arterial Disease and Early Neurological Deterioration in Acute Ischemic Stroke

“…It is noteworthy that the risk of END was similar in all arterial territories evaluated, but for a higher risk in the VB system. This observation agrees with the well-known higher risk of neurological deterioration in this territory [2,3,4,5,6,7,8,9]. …”

“…The rate of END in our study was 16.3%, similar to the END rates in previous studies that ranged from 13.9 to 32.2% [1,2,3,4,5,6,7,8,9], which can be explained by the diverse criteria used to evaluate the clinical worsening. Our definition of END was based on an increase in the NIHSS score of ≥4 points in the first 72 h, a restrictive criteria less influenced by subjective observations.…”