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首页> 外文期刊>Journal of Neurology Research >Spontaneous Neurological Deterioration in Acute Cardioembolic Stroke: A Subgroup of Patients With Early Severe Prognosis
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Spontaneous Neurological Deterioration in Acute Cardioembolic Stroke: A Subgroup of Patients With Early Severe Prognosis

机译：急性心脏栓塞性卒中的自发性神经系统恶化：早期严重预后的患者亚组

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Background: To determine clinical factors of spontaneous early neurological deterioration (END) and prognosis in a cohort of 480 consecutive patients with cardioembolic stroke (CS) without thrombolytic therapy hospitalized within 24 hours of the onset of symptoms.?Methods: END was defined as a drop of ≥ 1 point in the Canadian Stroke Scale or ≥ 2 points in the Glasgow Coma Scale between admission and after 72 hours. All patients underwent computerized tomography and/or MRI examination.?Results: END is present in 8.3% of CS patients. CS patients with END (n = 40) in comparison with patients without ND (n = 440) showed a worse early prognosis with statistically significant differences in absence of neurological deficit at hospital discharge (5% versus 17.3%), length of hospitalization (30.8 versus 18.5 days) and in-hospital mortality (47.5% versus 8.4%). In the multivariate analysis, early seizures, severe headache and hypertension were independent clinical predictors of END.?Conclusions: In patients with CS, early seizures, severe headache and hypertension are clinical variables associated with END. CS with END constitutes a subgroup of patients with severe prognosis. Because most causes of worsening can be treated effectively, the deteriorating cardioembolic stroke patient merits a swift and incisive diagnostic and therapeutic approach.doi:10.4021/jnr62w
机译：背景：为确定在症状发作后24小时内住院的480例未行溶栓治疗的连续性心脏栓塞性中风（CS）患者的自然早期神经系统恶化（END）和预后的临床因素。方法：将END定义为入院至72小时后，加拿大卒中量表下降≥1分或格拉斯哥昏迷量表下降≥2分。结果：8.3％的CS患者存在END。患有END的CS患者（n = 40）与没有ND的CS患者（n = 440）相比，显示出较差的早期预后，而出院时无神经功能缺损（5％vs 17.3％），住院时间（30.8）有统计学上的显着差异对比18.5天）和住院死亡率（分别为47.5％和8.4％）。在多变量分析中，早期癫痫发作，严重头痛和高血压是END的独立临床预测指标。结论：在CS患者中，早期癫痫发作，严重头痛和高血压是与END相关的临床变量。 END的CS构成预后严重的患者亚组。由于大多数恶化的原因都可以得到有效治疗，因此不断恶化的心脏栓塞性中风患者应采用迅速而敏锐的诊断和治疗方法。doi：10.4021 / jnr62w

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