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Prediction of Infarct Growth and Neurological Deterioration in Patients with Vertebrobasilar Artery Occlusions

Koh, S | Park, JH | Park, B  | Choi, MH  | Lee, SE  | Lee, JS  | Hong, JM  | Lee, SJ
Journal of clinical medicine, 9(11). : 3759-3759, 2020
Journal Title
Journal of clinical medicine
We aimed to identify predictors of infarct growth and neurological deterioration (ND) in vertebrobasilar occlusions (VBOs) with a focus on clinical-core mismatch. From 2010 to 2018, VBO patients were selected from a university hospital registry. In total, 138 VBO patients were included. In these patients, a posterior circulation Alberta Stroke Program Early CT score (PC-ASPECTS) less than 6 was associated with futile outcome. Within patients with feasible cores, a decrease in PC-ASPECTS score of 2 or more on follow-up imaging was classified as infarct growth and could be predicted by a National Institutes of Health Stroke Scale (NIHSS) mental status subset of 1 or higher (odds ratio (OR): 3.34, 95% confidence interval (CI) (1.19-9.38), p = 0.022). Among the 73 patients who did not undergo reperfusion therapy, 13 patients experienced ND (increase in discharge NIHSS score of 4 or more compared to the initial presentation). Incomplete occlusion (vs. complete occlusion, OR 6.17, 95% CI (1.11-34.25), p = 0.037), poorer collateral status (BATMAN score, OR: 1.91, 95% CI (1.17-3.48), p = 0.009), and larger infarct cores (PC-ASPECTS, OR: 1.96, 95% CI (1.11-3.48), p = 0.021) were predictive of ND. In patients with VBO, an initial PC-ASPECTS of 6 or more, but with a decrease in the mental status subset of 1 or more can predict infarct growth, and may be used as a criterion for clinical-core mismatch. ND in VBO patients presenting with milder symptoms can be predicted by incomplete occlusion, poor collaterals, and larger infarct cores.

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Journal Papers > School of Medicine / Graduate School of Medicine > Biomedical Informatics
Journal Papers > School of Medicine / Graduate School of Medicine > Neurology
Journal Papers > School of Medicine / Graduate School of Medicine > Emergency Medicine
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박, 범희  |  이, 성은  |  이, 성준  |  이, 진수  |  최, 문희  |  홍, 지만
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