Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital and Health Services of Trieste, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy.
Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio, 10, 34127, Trieste, Italy.
Neurol Sci. 2021 Oct;42(10):4231-4240. doi: 10.1007/s10072-021-05072-x. Epub 2021 Feb 16.
Diagnosis of posterior circulation stroke may be challenged. National Institutes of Health Stroke Scale (NIHSS) and brain imaging (non-contrast brain computed tomography-CT) are used for diagnosis; evaluation on posterior circulation stroke remains a limit of NIHSS, and the value of non-contrast CT (NCCT) is limited due to artifacts caused by the bones of the base of the skull. We tested the validity and prognostic value of posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS) in patients with posterior circulation stroke.
Pc-ASPECTS allots the posterior circulation 10 points. We studied 50 patients with posterior circulation stroke. We applied pc-ASPECTS to NCCT, CT angiography, and CT Perfusion. We evaluated the correlation of pc-ASPECT with outcome parameters for stroke.
Out of 50 patients, CTP showed abnormalities in 34 cases. The pc-ASPECT score calculated on brain CT and on the brain CT + angio CT had a sensibility of 24%, calculated on brain CT, angio CT and CTPerfusion gain a sensibility of 72%. Pc-ASPECT MTT resulted to be the more reliable parameter: outcome given by NIHSS score at discharge, mRS at discharge, and at 3 months was more severe in patients with Pc-ASPECT MTT alteration. Outcome given by NIHSS score at discharge and mRS at discharge and 1 at 3 months was more severe in patients with higher NIHSS score at admission.
We evaluated the usefulness of pc-ASPECTS on CTP in predicting functional outcome in acute posterior circulation stroke that appears to be a powerful marker for predicting functional outcome.
后循环卒中的诊断可能具有挑战性。国立卫生研究院卒中量表（NIHSS）和脑部影像学（非对比脑 CT）用于诊断；NIHSS 对后循环卒中的评估仍然存在局限性，非对比 CT（NCCT）的价值也因颅底骨骼造成的伪影而受到限制。我们在后循环卒中患者中测试了后循环 Alberta 卒中项目早期 CT 评分（pc-ASPECTS）的有效性和预后价值。
pc-ASPECTS 为后循环分配 10 分。我们研究了 50 例后循环卒中患者。我们在后循环 NCCT、CT 血管造影和 CT 灌注中应用 pc-ASPECTS。我们评估了 pc-ASPECT 与卒中预后参数的相关性。
50 例患者中，CTP 显示异常 34 例。脑 CT 和脑 CT + 血管造影 CT 计算的 pc-ASPECT 评分敏感性为 24%，脑 CT、血管造影 CT 和 CT 灌注计算的敏感性为 72%。Pc-ASPECT MTT 是更可靠的参数：出院时 NIHSS 评分、出院时 mRS 评分和 3 个月时 mRS 评分的结果，MTT 改变的患者预后更差。出院时 NIHSS 评分和 mRS 评分和 3 个月时 mRS 评分的结果，入院时 NIHSS 评分较高的患者预后更差。
我们在后循环 CT 灌注中评估了 pc-ASPECTS 在预测急性后循环卒中功能结局中的有用性，它似乎是预测功能结局的有力标志物。
