Thrombolytic therapy is an only determinant factor for stroke evolution in large anterior choroidal artery infarcts.

Abstract

BACKGROUND:

Large anterior choroidal artery (AChA) infarcts are frequently associated with stroke evolution. This study aimed to investigate the major determinants for stroke evolution in patients with large AChA infarcts.

METHODS:

We studied 118 consecutive adult patients with acute large AChA infarcts. The diagnosis was confirmed as abnormal hyperintensities in 3 or more rostracaudal magnetic resonance imaging slices (5 mm thickness) using diffusion-weighted imaging within typical AChA vascular regions. Stroke evolution was defined as neurologic deterioration with an increase in National Institutes of Health Stroke Scale (NIHSS) score by at least 4 or an increase of NIHSS score in motor function by at least 2 in 7 days after stroke onset.

RESULTS:

Forty-seven (39.8%) patients developed stroke evolution. Thrombolytic therapy was inversely associated with the occurrence of stroke evolution (P = .004). Using multivariate analysis, thrombolytic therapy was the only protective determinant for stroke evolution (adjusted odds ratio, .08; 95% confidence interval, .01 to .67). Patients with large AChA infarcts receiving thrombolytic therapy had less unfavorable long-term functional outcome than those not receiving thrombolytic therapy (adjusted odds ratio, .11; 95% confidence interval, .02-.75).

CONCLUSIONS:

Thrombolytic therapy is an only determinant factor for stroke evolution in large AChA infarcts, which reduced the risk of stroke evolution and improved functional outcome.

• Authors: Meng-Chen Wu, Li-Kai Tsai, Chung-Chu Wu, Shin-Joe Yeh, Sung-Chun Tang, Yun-Ju Chen, Chien-Lin Chen, Jiann-Shing Jeng
• Journal: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association (J Stroke Cerebrovasc Dis) 2014 May-Jun Vol. 23 Issue 5 Pg. 1089-93 ISSN: 1532-8511 [Electronic] United States
• PMID: 24135234 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Topics

• Aged
• Cerebral Infarction (diagnosis, drug therapy, physiopathology)
• Chi-Square Distribution
• Diffusion Magnetic Resonance Imaging
• Disability Evaluation
• Disease Progression
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Motor Activity
• Multivariate Analysis
• Neurologic Examination
• Odds Ratio
• Predictive Value of Tests
• Retrospective Studies
• Risk Factors
• Thrombolytic Therapy
• Treatment Outcome