Urgent diagnostics and treatment of cerebral infarction: one-year experience

Justina Aleksaitė1

1Republic Vilnius University Hospital


            Cerebral infarction is an important public health problem which is characterized by high mortality and disability rates that remain high even to this date and so it is crucial that we use the latest measures of diagnostics and treatment in order to keep the situation under control. Based on case histories we analyzed the results of Vilnius University Hospital Santaros clinics regarding the diagnostics and treatment of stroke. We also looked through main characteristics of stroke patients, the stroke itself (the neurologic deficit caused by it measured according to 5-sNIHSS score, cerebral circulation affected by the stroke, computed tomography findings), found the main risk factors that predict poor outcomes, compared the differences between the year 2014 and the first quarter of 2020 concerning the specific diagnostic (computed tomography angiography and/or perfusion) and therapeutic (thrombolysis and/or thrombectomy) measures both in general population as well as in age-related groups (ages 80 and up versus younger patients). Furthermore, we have calculated various time intervals (from first signs of disease to arrival at the hospital, door-to-CT scan, door-to-needle and such) which were also compared between the year 2014 and the first quarter of 2020. 2014 was the year that marked the implementation of new diagnostic and interventional treatment methods of stroke in Vilnius University Hospital Santaros clinics and because of that the results were not satisfactory compared to data provided by other authors but a great progress was made in the last couple of years and the situation in 2020 is remarkable so far: computed tomography angiography and perfusion are both being performed more often and with that the percentage of patients being treated with thrombolysis and thrombectomy increased as well both in elderly and younger patients alike. The door-to-CT scan and door-to-needle intervals were also reduced and today all the results are on par with the ones that are stated in literature.

Keywords: cerebral infarction, stroke, computed tomography, angiography, perfusion, thrombolysis, thrombectomy, time intervals, stroke outcomes.