Predictors of Good Prognosis in Total Anterior Circulation Infarction Within 6 H After Onset Under Conventional Therapy

Acta Neurol Scand. 2006 May;113(5):301-6. doi: 10.1111/j.1600-0404.2006.00584.x.

Abstract

Objective: We investigated the predictors of good prognosis in total anterior circulation infarction (TACI), under conventional therapy.

Methods: We enrolled 166 patients with first-ever ischemic stroke within 6 h after onset with symptoms of TACI. Sixty-three patients (38.0%) with good outcome [G group, the modified Rankin Disability Scale (mRS) after 3 months < or =3] and 103 patients (62.0%) with bad outcome (B group, mRS >3) were compared.

Results: On univariate analysis, G group patients were significantly younger, had lower score in the National Institutes of Health Stroke Scale (NIHSS) of total and consciousness sub-score, had lower rate of clinical deterioration. On cranial CT at entry, three early CT signs [hyperdense middle cerebral artery (MCA) sign, hypodensity of >1/3 MCA and brain swelling] were significantly more frequent in the B group. On the second CT at 24-48 h, infarct area as assessed by the Alberta Stroke Programme Early CT Score (ASPECTS) was significantly smaller in the G group. Multivariate analysis with logistic regression revealed age <7 0 years, NIHSS < or =15, no clinical deterioration, and only no brain swelling in early CT signs, and ASPECTS > or =7 as independent predictors of good prognosis.

Conclusions: Some clinical variables are useful in predicting outcome in TACI within the early period after stroke onset.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brain Infarction / drug therapy*
  • Brain Infarction / pathology
  • Disability Evaluation
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Predictive Value of Tests
  • Retrospective Studies
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Platelet Aggregation Inhibitors