Dovilė Geštautaitė¹, Gertrūda Rudaitytė¹, Evaldas Keleras²
¹Lithuanian university of health sciences,medical academy, faculty of medicine
² Lithunian university of health sciences hospital, Radiology clinic
The aim: to evaluate the correlation between the results of radiological examinations (CT and CTA) and neurological status of the patients with cerebral ischemic stroke.
Methods: a retrospective study was performed in which the data of CT, CTA and neurological status from the hospital of Lithuanian University of Health Sciences (LUHS) Kaunas Clinics Neurology and Radiology departments were analyzed. Patients who had middle cerebral artery (MCA) occlusion stroke in the period of January 2018 – January 2019 were involved in this study. Data analysis was performed with „IBM SPSS 22.0“ and „MS Office Excel 2010“ programs. Statistical significance level p<0,05.
Results: out of the 100 patients, 50 were men (50 proc.) and 50 (50 proc.) were women. The age of the patients ranged from 34 to 96 years old, mean 72,7±12,31 years old. The ischemic zone volumes ranged from 0,31 to 266,562 ml, mean 41,7914 ± 60,7193 ml. The positive correlation was found between the volume of the ischemic zone and the neurological status of the patients (r = 0,730, p<0,01). In most cases patients were evaluated with 8 ASPECTS scores (19%). ASPECTS 0-4 points were evaluated for 27 patients (27%), 5-7 for 40 patients (40%) and 8-10 points for 33 patients (33%). The positive correlation was found between the ischemic area and the neurological condition deficiency (p <0,05). MTE was performed for 39 patients (29,5%). Numerous cases of M2 segment occlusion were diagnozed, more precisely for 22 patients (56,41%), while M1 segment occlusion for 17 patients (43,59%). The bigger neurological deficit in the initial period of the disease, 24 hours and 7 days after ishemic stroke was for patients with M1 segment occlusion of MCA (p = 0,031). The intracerebral hemorrhage occurred in 33 patients (33%). It was identified that bigger intracerebral hemorrgahes by ECASS caused a significantly higher neurological deficit throughout the early period of the disease (p <0,05).
Conlusions: 1. At a higher volume of ischemic area after ishemic stroke, the neurological condition is more severe. 2. The higher the ischemic area of the ASPECTS score, the more severe the neurological condition. 3. If M1 segment occlusion occurs, the neurological condition is more severe. 4. Larger intracerebral haemorrhages result in a more severe neurological condition.
Keywords: ischemic stroke, computed tomography, computed tomography angiography