Impact of Leukoaraiosis Burden on Hemispheric Lateralization of the National Institutes of Health Stroke Scale Deficit in Acute Ischemic Stroke
Impact of Leukoaraiosis Burden on Hemispheric Lateralization of the National Institutes of Health Stroke Scale Deficit in Acute Ischemic Stroke
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DOI：
10.1161/strokeaha.115.011771
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发表时间：
2016-01-01
期刊：
影响因子：
8.3
通讯作者：
Henninger, Nils
中科院分区：
文献类型：
--
作者：
Helenius, Johanna;Goddeau, Richard P., Jr.;Henninger, Nils
研究背景和目的：美国国立卫生研究院卒中量表（NIHSS）对优势半球梗死患者的功能缺损评分高于非优势半球梗死患者。这已被证明会对中风识别、治疗决策和结果产生不利影响。然而，改变梗死侧和缺损严重程度之间关系的因素还不完全清楚。因此，我们试图确定年龄和年龄相关性脑白质疏松症是否改变NIHSS缺陷评分和侧和体积infarct.Methods之间的关系，我们研究了238例幕上，非腔隙性缺血性梗死前瞻性纳入我们的中风登记在2013年1月至2014年1月。在就诊时评估NIHSS缺损严重程度。通过弥散加权成像的手动平面测量法评估CT体积。根据Fazekas量表，在液体衰减反转恢复图像上对白质疏松负担进行分级，并将其分为无至轻度（0-2）与重度（3-6）。采用多元线性回归向后消除法确定入院时NIHSS的独立预测因素。
Background and Purpose The National Institutes of Health Stroke Scale (NIHSS) awards higher deficit scores for infarcts in the dominant hemisphere when compared with otherwise similar infarcts in the nondominant hemisphere. This has been shown to adversely affect stroke recognition, therapeutic decisions, and outcome. However, factors modifying the association between infarct side and deficit severity are incompletely understood. Thus, we sought to determine whether age and age-related leukoaraiosis alter the relation between NIHSS deficit score and the side and volume of infarction.Methods We studied 238 patients with supratentorial, nonlacunar ischemic infarcts prospectively included in our stroke registry between January 2013 and January 2014. NIHSS deficit severity was assessed at the time of presentation. Infarct volumes were assessed by manual planimetry on diffusion-weighted imaging. Leukoaraiosis burden was graded on fluid-attenuated inversion recovery images according to the Fazekas scale and dichotomized to none-to-mild (0-2) versus severe (3-6). Multivariable linear regression with backward elimination was used to identify independent predictors of the admission NIHSS.Results Left-hemispheric infarction (P