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Preexisting Cerebral Abnormalities and Functional Outcomes After Acute Ischemic Stroke
- Source :
- Journal of Geriatric Psychiatry and Neurology. 32:327-335
- Publication Year :
- 2019
- Publisher :
- SAGE Publications, 2019.
-
Abstract
- Purpose: The aim of this study was to investigate the association between preexisting cerebral abnormalities in patients with acute ischemic stroke upon their functional outcomes. Methods: We recruited 272 patients with first-ever acute ischemic stroke. Cerebral abnormalities on magnetic resonance imaging included infarction, silent brain infarcts (SBI), enlarged perivascular spaces, white matter lesions (WMLs), global brain atrophy, and medial temporal lobe atrophy (MTLA). Functional outcomes were assessed using the instrumental activities of daily living (IADL) scale and basic activities of daily living (BADL) scale, at 3 and 6 months after the index stroke. Results: Two hundred and fifty patients completed the 3-month follow-up and 246 patients completed the 6-month follow-up. Univariate analyses showed that patients with poor IADL and BADL were older, more likely to be men, had higher National Institutes of Health Stroke Scale (NIHSS) score on admission, more frequent atrial fibrillation, and large artery atherosclerosis subtypes. They also had more frequent cortical infarcts, subcortical infarcts, infratentorial infarcts, larger infarct volume, more frequent presence of SBI, severe WMLs, and MTLA. In multiple regression analyses, NIHSS on admission, subcortical region infarct and MTLA were significant predictors of poor IADL at 3 months. National Institutes of Health Stroke Scale on admission, SBI and MTLA were significant predictors of poor IADL at 6 months. National Institutes of Health Stroke Scale on admission and MTLA were significant predictors of poor BADL at 3 months. National Institutes of Health Stroke Scale on admission and SBI were significant predictors of poor BADL at 6 months. Conclusions: In patients with acute ischemic stroke, the presence of SBI, and severe MTLA represent significant predictors of poorer functional outcomes, thus highlighting the importance of preexisting cerebral abnormalities.
- Subjects :
- Adult
Male
medicine.medical_specialty
Infarction
030204 cardiovascular system & hematology
Brain Ischemia
Young Adult
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Brain mri
Humans
In patient
cardiovascular diseases
Cerebrum
Acute ischemic stroke
Aged
Aged, 80 and over
business.industry
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Stroke
Psychiatry and Mental health
Cardiology
Female
Functional status
Neurology (clinical)
Geriatrics and Gerontology
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15525708 and 08919887
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Journal of Geriatric Psychiatry and Neurology
- Accession number :
- edsair.doi.dedup.....9d14787a5dbbd6069a7fdb5634040938