Mild neurological symptoms despite middle cerebral artery occlusion

Stroke. 2004 Feb;35(2):469-71. doi: 10.1161/01.STR.0000110985.01773.7F. Epub 2004 Jan 15.

Abstract

Background and purpose: Only a small percentage of stroke patients are treated with thrombolytic therapy. We sought to determine whether vessel occlusion in mild strokes represented a new target population for interventional therapy.

Methods: We imaged 106 acute stroke patients with MRI. Patients were identified with evidence of middle cerebral artery (MCA) occlusion and mild or no stroke signs (National Institutes of Health Stroke Scale [NIHSS] <or=3). They were compared with patients with signs of stroke, NIHSS >3, and MCA occlusion.

Results: We identified 5 patients with absent flow on MRA in the MCA and mild or no stroke signs (NIHSS <or=3). All 5 were functionally independent at 3 months.

Conclusions: Caution should be exercised in considering thrombolytic therapy in these patients. Quantification of perfusion imaging is required to identify "at risk" mild stroke populations.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Aged
  • Blood Flow Velocity
  • Cerebrovascular Circulation*
  • Diffusion Magnetic Resonance Imaging
  • Female
  • Humans
  • Infarction, Middle Cerebral Artery / complications
  • Infarction, Middle Cerebral Artery / diagnosis*
  • Infarction, Middle Cerebral Artery / physiopathology*
  • Ischemic Attack, Transient / diagnosis
  • Ischemic Attack, Transient / etiology
  • Ischemic Attack, Transient / physiopathology
  • Magnetic Resonance Angiography
  • Male
  • Middle Aged
  • Middle Cerebral Artery / diagnostic imaging
  • Middle Cerebral Artery / pathology
  • Middle Cerebral Artery / physiopathology
  • Predictive Value of Tests
  • Prospective Studies
  • Recovery of Function
  • Severity of Illness Index
  • Stroke / diagnosis*
  • Stroke / etiology
  • Stroke / physiopathology*
  • Tomography, X-Ray Computed