Usefulness of a single-parameter tool for the prediction of large vessel occlusion in acute stroke

Leibinger, Franck; Allou, Thibaut; Damme, Laurène Van; Jebali, Chawki; Arquizan, Caroline; Farouil, Geoffroy; Laverdure, Alexandre; Gaillard, Nicolas; Ibanez, Majo; Smadja, Philippe; Dutray, A.; Tardieu, Maxime; Them, Ludovic Nguyen; Ousji, Ali; Jurici, Snejana; Gascou, Grégory; Bensalah, Zoubir Mourad; Olivier, Nadège; Damon, F.; Chaabane, Wael; Fadat, Bénédicte; Lachcar, Marlène; Mas, Julie; Mourand, Isabelle; Ferraro, A.; Héve, D.; Dumitrana, Adrian; Blenet, Jean-Christophe; Aptel, Sabine; Costalat, Vincent; Bonafé, Alain; Ortega, Loréna; Sablot, Denis

doi:10.1007/s00415-020-10286-8

Cited by 3 publications

(2 citation statements)

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“…Out of the 5 studies observing stand-alone physical symptoms included in this review, 2 studies focused on eye deviation (66,67), 1 study focused on cortical symptoms ( 68), 1 study focused on complete hemiplegia (69), and 1 study focused on neurological symptoms for predicting LVO (70).…”

Section: Physical Symptomsmentioning

confidence: 99%

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Emerging Detection Techniques for Large Vessel Occlusion Stroke: A Scoping Review

et al. 2022

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Background: Large vessel occlusion (LVO) is the obstruction of large, proximal cerebral arteries and can account for up to 46% of acute ischaemic strokes (AIS) when both the A2 and P2 segments are included (from the anterior and posterior cerebral arteries). It is of paramount importance that LVO is promptly recognised to provide timely and effective acute stroke management. This review aims to scope recent literature to identify new emerging detection techniques for LVO. As a good comparator throughout this review, the commonly used National Institutes of Health Stroke Scale (NIHSS), at a cut-off of ≥11, has been reported to have a sensitivity of 86% and a specificity of 60% for LVO.Methods: Four electronic databases (Medline via OVID, CINAHL, Scopus, and Web of Science), and grey literature using OpenGrey, were systematically searched for published literature investigating developments in detection methods for LVO, reported from 2015 to 2021. The protocol for the search was published with the Open Science Framework (10.17605/OSF.IO/A98KN). Two independent researchers screened the titles, abstracts, and full texts of the articles, assessing their eligibility for inclusion.Results: The search identified 5,082 articles, in which 2,265 articles were screened to assess their eligibility. Sixty-two studies remained following full-text screening. LVO detection techniques were categorised into 5 groups: stroke scales (n = 30), imaging and physiological methods (n = 15), algorithmic and machine learning approaches (n = 9), physical symptoms (n = 5), and biomarkers (n = 3).Conclusions: This scoping review has explored literature on novel and advancements in pre-existing detection methods for LVO. The results of this review highlight LVO detection techniques, such as stroke scales and biomarkers, with good sensitivity and specificity performance, whilst also showing advancements to support existing LVO confirmatory methods, such as neuroimaging.

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Section: Physical Symptomsmentioning

confidence: 99%

“…The authors' ratings system was optimised to have a low false positive rate so that patients with low NIHSS scores at initial presentation were not missed (68). Complete hemiplegia demonstrated high specificity for predicting LVO (94%) but lacked sensitivity in both derivation and validation cohorts (69).…”

Section: Physical Symptomsmentioning

confidence: 99%