Detailed Information

Cited 0 time in webofscience Cited 1 time in scopus
Metadata Downloads

Frequency, management, and outcomes of early neurologic deterioration due to stroke progression or recurrence

Authors
Kim, Joon-TaeLee, Ji SungKim, Beom JoonPark, Jong-MooKang, KyusikLee, Soo JooKim, Jae GukCha, Jae-KwanKim, Dae-HyunPark, Tai HwanLee, Dh Kyung BokLee, JunHong, Keun-SikCho, Yong-JinPark, Hong-KyunLee, Byung-ChulYu, Kyung-HoOh, Mi SunKim, Dong-EogRyu, Wi-SunChoi, Jay CholKwon, Jee-HyunKim, Wook-JooShin, Dong-IckYum, Kyu SunSohn, Sung IlHong, Jeong-HoLee, Sang-HwaPark, Man-SeokChoi, Kang-HoLee, JuneyoungSaver, Jeffrey L.Bae, Hee-Joon
Issue Date
Feb-2023
Publisher
W. B. Saunders Co., Ltd.
Keywords
Early neurologic deterioration; Stroke progression; Stroke recurrence; Acute ischemic stroke; END management
Citation
Journal of Stroke and Cerebrovascular Diseases, v.32, no.2
Journal Title
Journal of Stroke and Cerebrovascular Diseases
Volume
32
Number
2
URI
https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/21957
DOI
10.1016/j.jstrokecerebrovasdis.2022.106940
ISSN
1052-3057
1532-8511
Abstract
Objective: The frequency, management, and outcomes of early neurologic deteriora-tion (END) after ischemic stroke specifically due to stroke progression or stroke recurrence have not been well delineated. Materials and methods: In a multicenter, nationwide registry, data on END due to stroke progression or recurrence con-firmed by imaging were collected prospectively between January 2019 and July 2020. Patient characteristics, management strategies, and clinical outcomes were analyzed. Results: Among 14,828 consecutive ischemic stroke patients, 1717 (11.6%) experienced END, including 1221 (8.2%) with END due to stroke progression (SP) or stroke recurrence (SR). Active management after END was implemented in 64.2% of patients. Active management strategies included volume expansion (29.2%), change in antithrombotic regimen (26.1%), induced hypertension (8.6%), rescue reperfusion therapy (6.8%), intracranial pressure lowering with hyperosmo-lar agents (1.5%), bypass surgery (0.6%), and hypothermia (0.1%). Active manage-ment strategies that varied with patient features included volume expansion and induced hypertension, used more often in large artery atherosclerosis and small vessel occlusion, and rescue endovascular thrombectomy, more common in other (dissection), cardioembolism, and large artery atherosclerosis. Active management was associated with higher rates of freedom from disability (modified Rankin Scale, mRS, 0-1; 24.3% vs. 16.6%) and functional independence (mRS, 0-2; 41.6% vs. 27.7%) at 3 months. Conclusion: END specifically due to stroke progression or recur-rence occurs in 1 in 12 acute ischemic stroke patients. In this observational study, active management, undertaken in two-thirds of patients, was most often hemody-namic or antithrombotic and was associated with improved functional outcomes.
Files in This Item
There are no files associated with this item.
Appears in
Collections
College of Medicine > Department of Neurology > 1. Journal Articles

qrcode

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

Related Researcher

Researcher Lee, Kyung Bok photo

Lee, Kyung Bok
College of Medicine (Department of Neurology)
Read more

Altmetrics

Total Views & Downloads

BROWSE