Please use this identifier to cite or link to this item: http://dspace.sctimst.ac.in/jspui/handle/123456789/9884
Title: Imaging and Clinical Predictors of Unfavorable Outcome in Medically Treated Symptomatic Intracranial Atherosclerotic Disease
Authors: Kate, M
Sylaja, PN
Kesavadas, C
Thomas, B
Keywords: Neurosciences & Neurology; Cardiovascular System & Cardiology
Issue Date: 2014
Publisher: JOURNAL OF STROKE & CEREBROVASCULAR DISEASES
Citation: 23 ,5;973-978
Abstract: Background: Patients with symptomatic intracranial atherosclerotic disease (sICAD) have an increased risk of stroke and vascular death. The aim of the study was to evaluate the natural history and outcome of patients with sICAD treated medically. Methods: The study population was first-ever transient ischemic attack (TIA) or stroke patients presenting to our institute who on vascular imaging had isolated intracranial atherosclerosis as cause of their symptoms and have a follow-up of 90 days. Unfavorable outcome was defined as occurrence of TIA, stroke, acute coronary event, and/or vascular death. Results: Fifty-three (11.8%) of the 449 ischemic stroke patients had sICAD. The risk of stroke in sICAD was 8.9%, 11.1%, 13.3%, and 15.6% in first 7 days, 30 days, 90 days, and 1 year, respectively. Five (11.1%) had cardiovascular events and accounted for 50% of mortality. The predictors of unfavorable outcome were presented as limb weakness (85.7% versus 58.8%, hazard ratio 1.5; 95% confidence interval [CI], .05-.9; P = .04), National Institutes of Health Stroke Scale (NIHSS) score 8 at admission (50% versus 5.9%, hazard ratio 8.5; 95% CI, .007-.5; P = .02), magnetic resonance imaging (MRI) with multiple diffusion-weighted imaging (DWI) lesions (65.4% versus 26.7%; 95% CI,.04-. 7; P = .01), and angiography suggestive of diffuse atherosclerosis (50% versus 11.8%; 95% CI, odds ratio .02-. 7; P = .009). On stepwise multiple regression, variables for unfavorable outcome were NIHSS score of 8 or more at admission (P = .001), multiple DWI lesion on MRI (P 5.04), and diffuse atherosclerosis on angiography (P = .006). Conclusion: The patients with sICAD have a high risk of stroke and cardiac events even on aggressive medical treatment. Clinical and imaging features can identify this high-risk group.
URI: 10.1016/j.jstrokecerebrovasdis.2013.08.002
http://dspace.sctimst.ac.in/jspui/handle/123456789/9884
Appears in Collections:Journal Articles

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.