From the Neurological Intervention and Imaging Service of Western Australia (A.H.C., W.M.), Western Australia Health, Sir Charles Gairdner, Royal Perth, and Fiona Stanley Hospitals, Perth, Australia
Medical School, Division of Medicine (A.H.C., W.M.), University of Western Australia, Perth, Australia.
AJNR Am J Neuroradiol. 2020 Apr;41(4):645-649. doi: 10.3174/ajnr.A6497. Epub 2020 Mar 26.
Use of mechanical thrombectomy for stroke has increased since the publication of trials describing outcome improvement when used in the anterior circulation. These results, however, cannot be directly translated to the posterior circulation. While a high NIHSS score has demonstrated an association with poor outcomes in posterior stroke, the NIHSS is weighted toward hemispheric disease, and complex scores potentially delay definitive imaging diagnosis. We performed a retrospective analysis to ascertain whether any rapidly obtainable demographic or clinical and imaging data have a correlation with patient outcome postthrombectomy. Seventy-three cases were audited between September 2010 and October 2017. Presenting with a Glasgow Coma Scale score of >13 meant that the odds of reaching the primary end point of functional independence (defined as a 90-day modified Rankin Scale score of 0-2) were 5.70 times greater; similarly, presenting with a posterior circulation ASPECTS of >9 resulted in the odds of reaching the primary end point being 4.03 times greater. (0.97, = .04).
自描述机械取栓术在前循环中改善预后的试验发表以来，其在脑卒中的应用有所增加。然而，这些结果并不能直接转化到后循环。虽然 NIHSS 评分高与后循环卒中的不良预后相关，但 NIHSS 偏向于半球疾病，复杂的评分可能会延迟明确的影像学诊断。我们进行了一项回顾性分析，以确定任何可快速获得的人口统计学或临床和影像学数据是否与血栓切除术后的患者预后相关。在 2010 年 9 月至 2017 年 10 月期间，我们对 73 例患者进行了审核。格拉斯哥昏迷评分（Glasgow Coma Scale）＞13 意味着达到主要终点（功能性独立定义为 90 天改良 Rankin 量表评分 0-2）的几率增加了 5.70 倍；同样，后循环 ASPECTS 评分＞9 也使达到主要终点的几率增加了 4.03 倍。（97，=.04）。
