A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke

ÖZDEMİR, Özcan; Ozkan, Serhat; BAŞ, Demet Funda; Uzuner, Nevzat; ÇOLAK, Ertuğrul

A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke

Özcan ÖZDEMİR, (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Eskişehir, Türkiye)

Demet Funda BAŞ, (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Eskişehir, Türkiye)

Serhat ÖZKAN, (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Eskişehir, Türkiye)

Ertuğrul ÇOLAK, (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Eskişehir, Türkiye)

Nevzat UZUNER (Eskişehir Osmangazi Üniversitesi, Tıp Fakültesi, Nöroloji Anabilim Dalı, Eskişehir, Türkiye)

Journal of Neurological Sciences (Turkish)

2 0

Yıl: 2015 Cilt: 32 Sayı: 4 Sayfa Aralığı: 636 - 648 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke

Öz:

Amaç: Bu çalışmanın amacı, intravenöz rekombinant doku plazminojen aktivatörü (iv rtPA) uygulanan akut iskemik inme hastalarında Hiperdens İnternal Karotid Arter İşareti (HICAS), Hiperdens Orta Serebral Arter İşareti (HMCAS) ve Orta Serebral Arter Nokta İşareti'nin klinik özelliklerini ve klinik sonlanım üzerindeki etkilerini değerlendirmektir. Yöntemler: iv rtPA uygulanan 252 anterior sirkülasyon akut iskemik inme hastasının Bilgisayarlı Tomografi (BT) kesitleri, klinik bulguları ve sonlanımları incelendi. Başvuru esnasındaki BT kesitleri hiperdens arter işareti (HAS) varlığı açısından değerlendirildi. Uygun olan hastalarda rekanalizasyon transkranial doppler (TCD) ile gözlendi. Bulgular: 252 hastanın 99'unda HAS mevcuttu; 12 HICAS; 64 HMCAS ve 23 orta serebral arter nokta işareti. HICAS+ hastaların hiçbirinde 3üncü ayda iyi klinik sonlanım gözlenmedi. HMCAS+ hastalar istatistiksel açıdan belirgin şekilde daha az iyi sonlanıma ulaştılar. Mortalite HICAS+ ve HMCAS+ hastalarda istatistiksel açıdan belirgin olarak artmıştı. Orta serebral arter nokta işareti başvuru nörolojik bulgularda, rekanalizasyonda, iyi sonlanımda veya mortalitede anlamlı bir farklılık yaratmadı. 3üncü ayın sonunda HICAS+ ve HMCAS+ hastalar arasında belirgin farklılık görülmezken orta serebral arter işareti olan hastalar HICAS+ ve HMCAS+ hastalara kıyasla daha iyi mRS skorlarına ulaştılar. HMCAS varlığı, bazal serum glukoz düzeyi ve başvuru NIHSS skorları kötü sonlanımın bağımsız risk faktörleri olarak saptandı. Sonuç: iv rtPA uygulanan akut iskemik inme hastalarında, HICAS veya HMCAS varlığı yetersiz rekanalizasyon ve kötü sonlanımla ilişkili bulunurken, orta serebral arter nokta işareti farklı bir sınıfı oluşturmaktadır ve klinik seyir ve sonlanım üzerinde belirgin bir etkide bulunmamaktadır

Anahtar Kelime:

Konular: Nörolojik Bilimler

Akut İskemik İnme Hastalarında Hiperdens İnternal Karotid Arter İşareti, Hiperdens Orta Serebral Arter İşareti ve Orta Serebral Arter Nokta İşareti'nin Karşılaştırılması

Öz:

Background: The aim of this study was to evaluate the clinical features of hyperdense internal carotid artery sign (HICAS), hyperdense middle cerebral artery sign (HMCAS) and MCA dot sign to understand their effect on the outcomes of acute ischemic stroke patients treated with intravenous recombinant tissue plasminogen activator (iv rtPA). Methods: Computed tomography (CT) scans, clinical features and outcomes of 252 patients with anterior circulation acute ischemic stroke treated with iv rtPA were evaluated. Initial CT scans were evaluated for hyperdense artery sign (HAS). Recanalization was evaluated with transcranial Doppler (TCD) in all available patients. Results: 99 of 252 patients had HAS; 12 had HICAS, 64 had HMCAS and 23 had MCA dot sign. None of the HICAS+ patients had a favorable outcome at three months. HMCAS+ patients achieved significantly less favorable outcomes. Mortality increased significantly in HICAS+ and HMCAS+ patients. MCA dot sign did not make a significant difference on baseline neurological status, recanalization, favorable outcome or mortality. At three months, there was no significant differences between HICAS and HMCAS whereas the MCA dot sign patients had better mRS scores compared with HICAS and HMCAS patients. HMCAS presence, baseline glucose levels and baseline NIHSS scores were all independent predictors of poor outcome. Conclusion: In acute ischemic stroke patients treated with iv rtPA, the presence of HICAS or HMCAS was found to be associated with insufficient recanalization and poor outcome, whereas MCA dot sign was a different entity and did not significantly influence the clinical course or outcome

Anahtar Kelime:

Konular: Nörolojik Bilimler

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	ÖZDEMİR Ö, BAŞ D, Ozkan S, ÇOLAK E, Uzuner N (2015). A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. , 636 - 648.
Chicago	ÖZDEMİR Özcan,BAŞ Demet Funda,Ozkan Serhat,ÇOLAK Ertuğrul,Uzuner Nevzat A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. (2015): 636 - 648.
MLA	ÖZDEMİR Özcan,BAŞ Demet Funda,Ozkan Serhat,ÇOLAK Ertuğrul,Uzuner Nevzat A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. , 2015, ss.636 - 648.
AMA	ÖZDEMİR Ö,BAŞ D,Ozkan S,ÇOLAK E,Uzuner N A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. . 2015; 636 - 648.
Vancouver	ÖZDEMİR Ö,BAŞ D,Ozkan S,ÇOLAK E,Uzuner N A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. . 2015; 636 - 648.
IEEE	ÖZDEMİR Ö,BAŞ D,Ozkan S,ÇOLAK E,Uzuner N "A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke." , ss.636 - 648, 2015.
ISNAD	ÖZDEMİR, Özcan vd. "A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke". (2015), 636-648.

APA	ÖZDEMİR Ö, BAŞ D, Ozkan S, ÇOLAK E, Uzuner N (2015). A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. Journal of Neurological Sciences (Turkish), 32(4), 636 - 648.
Chicago	ÖZDEMİR Özcan,BAŞ Demet Funda,Ozkan Serhat,ÇOLAK Ertuğrul,Uzuner Nevzat A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. Journal of Neurological Sciences (Turkish) 32, no.4 (2015): 636 - 648.
MLA	ÖZDEMİR Özcan,BAŞ Demet Funda,Ozkan Serhat,ÇOLAK Ertuğrul,Uzuner Nevzat A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. Journal of Neurological Sciences (Turkish), vol.32, no.4, 2015, ss.636 - 648.
AMA	ÖZDEMİR Ö,BAŞ D,Ozkan S,ÇOLAK E,Uzuner N A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. Journal of Neurological Sciences (Turkish). 2015; 32(4): 636 - 648.
Vancouver	ÖZDEMİR Ö,BAŞ D,Ozkan S,ÇOLAK E,Uzuner N A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke. Journal of Neurological Sciences (Turkish). 2015; 32(4): 636 - 648.
IEEE	ÖZDEMİR Ö,BAŞ D,Ozkan S,ÇOLAK E,Uzuner N "A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke." Journal of Neurological Sciences (Turkish), 32, ss.636 - 648, 2015.
ISNAD	ÖZDEMİR, Özcan vd. "A Comparison of Hyperdense Internal Carotid Artery Sign, Hyperdense Middle Cerebral Artery Sign and Middle Cerebral Artery Dot Sign in Acute Ischemic Stroke". Journal of Neurological Sciences (Turkish) 32/4 (2015), 636-648.