Journal of Korean Society of Geriatric Neurosurgery 2018;14(1):11-15.
Published online June 30, 2018.
Characteristics of the Degree of Early Neurological Deterioration in Acute Ischemic Stroke
Hak Sung Kim1 , Hyun Goo Kang2 , Sang Woo Ha1
Departmenst of 1Neurosurgery and 2Neurology, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea
급성기 뇌경색에서 조기 신경학적 악화의 정도에 따른 특징
김학성1·강현구2·하상우1
조선대학교 의과대학 신경외과학교실1, 신경과학교실2
Abstract
Objective
Early neurological deterioration (END) in acute ischemic stroke occurs within a few hours or a few days after the onset of symptoms and is caused by various pathophysiological mechanisms. The purpose of this study is to investigate the cause of cerebral infarction, and the association of risk factors for END.
Methods
This is a retrospective study of patients with acute cerebral infarction who were admitted to our hospital from January 2010 to December 2015. Subjects were included in the study when acute cerebral infarction was identified in diffusion-weighted magnetic resonance imaging patients. The definition of END means that the National Institutes of Health Stroke Scale score is increased more than 1 point in the intensive care unit within 72 hours of symptom onset. In this study, we analyzed according to each score group.
Results
According to the location of the lesion, the lesions in the lenticulostriate artery and middle cerebral artery regions were more likely to cause END. Patients with greater score changes had more cardioembolic infarction with arrhythmia. Patients with worsening symptoms also had a longer hospital stay and had a higher rate of receiving Intensive Care Unit (ICU) treatment. Many patients had cardiac dysrhythmia,and the proportion of patients with vascular stenosis was also high.
Conclusion
END was different according to the location of the lesion and more frequently occurred in patients with cardioembolic infarction. These symptoms may lead to ICU treatment and death, so it is important to identify the triggering factors and to cope early.
Key Words: Brain ischemia, Cerebral infarction, Magnetic resonance imaging, National Institutes of Health Stroke Scale, Stroke


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