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Early dramatic recovery after successful endovascular reperfusion for acute cerebral major artery occlusion
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- Funatsu Naoko
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center Department of Neurosurgery, Gifu University Hospital
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- Hayakawa Mikito
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
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- Yamagami Hiroshi
- Division of Stroke Care Unit, National Cerebral and Cardiovascular Center
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- Yoshimoto Takeshi
- Department of Neurology, National Cerebral and Cardiovascular Center
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- Sonoda Kazutaka
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
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- Satow Tetsu
- Department of Neurosurgery, National Cerebral and Cardiovascular Center
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- Takahashi Jun C.
- Department of Neurosurgery, National Cerebral and Cardiovascular Center
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- Nagatsuka Kazuyuki
- Department of Neurology, National Cerebral and Cardiovascular Center
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- Toyoda Kazunori
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center
Bibliographic Information
- Other Title
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- 急性期脳主幹動脈閉塞に対する血管内治療後の転帰良好例における早期症候改善についての検討
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Description
<p>Background and purpose: Timings of symptom improvement of acute ischemic stroke patients who obtained successful endovascular reperfusion with subsequent favorable outcome at 90 days are not uniform. The purpose of this study was to clarify factors related to early symptom improvement after successful endovascular reperfusion. Methods: Among consecutive stroke patients treated using endovascular therapy at our institute between April 2012 and March 2016, we retrospectively reviewed those who obtained successful (Thrombolysis In Cerebral Infarction grade ≥2b) with subsequent favorable outcome defined as a modified Rankin Scale score of 0–2 at 90 days. Early dramatic recovery (EDR) was defined as an improvement of ≥10 points in National Institutes of Health Stroke Scale (NIHSS) score or a total score of 0–3 at 24 h after onset compared with the pretreatment score. Results: A total of 53 patients (mean age, 70.3±12.1 years; 17 females; median pretreatment NIHSS score, 15; interquartile range (IQR), 11–21) were included. The leading cause of stroke was cardioembolism (36 patients) and 30 patients received intravenous thrombolysis. EDR occurred in 45 patients (85%). Patients with EDR had lower white blood cell counts (7826.7±2827.7 vs. 10,137.5±3112.2/μl, p=0.03; adjusted odds ratio (OR), 0.99; 95% confidence interval (CI), 0.99–1.00) and lower blood urea nitrogen (BUN)/serum creatinine (Cre) ratio (18.1±6.0 vs. 24.7±8.1, p=0.02; adjusted OR, 0.81; 95%CI, 0.65–0.94) compared with those without EDR. In addition, patients with EDR showed better 90-day clinical outcome (median modified Rankin Scale score, 1 (IQR, 0–2) vs. 2 (IQR, 1–2), p=0.03) than those without. Conclusions: Lower BUN/Cre ratio was associated with EDR in acute stroke patients who obtained successful endovascular reperfusion with subsequent favorable outcome at 90 days.</p>
Journal
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- Cerebral Blood Flow and Metabolism (Japanese journal of cerebral blood flow and metabolism)
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Cerebral Blood Flow and Metabolism (Japanese journal of cerebral blood flow and metabolism) 28 (2), 257-263, 2017
The Japanese Society of Cerebral Blood Flow and Metabolism
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Details 詳細情報について
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- CRID
- 1390001205757412096
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- NII Article ID
- 130006008229
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- ISSN
- 21887519
- 09159401
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- Text Lang
- ja
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- Article Type
- journal article
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
- KAKEN
- OpenAIRE
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- Abstract License Flag
- Disallowed